Sanjay Dube, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C170424 Issued in CA

Practice address

29751 Monarch Dr
San Juan Capistrano, CA 92675-1427

Phone

(949) 633-0837

NPI assigned

Jun 16, 2021

Last updated

Jun 16, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1184292930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29751 MONARCH DR",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751427",
            "telephone_number": "949-633-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29751 MONARCH DR",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751427",
            "telephone_number": "949-633-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBE",
        "first_name": "SANJAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C170424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.