Sridhara K S Iyengar M D Inc

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

C42391 Issued in CA

Legal business name

SRIDHARA K S IYENGAR M D INC

Practice address

11100 Warner Ave
Ste 320
Fountain Valley, CA 92708-7506

Phone

(714) 549-1294

Fax

(714) 549-1296

NPI assigned

Jun 2, 2009

Organization subpart

No

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

Authorized official

Name

Sridhara K S Iyengar, M D

Title

Owner

Phone

(714) 549-1294

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1912133166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 320",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-549-1294",
            "fax_number": "714-549-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "STE 320",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-549-1294",
            "fax_number": "714-549-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRIDHARA K S IYENGAR M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "IYENGAR",
        "authorized_official_first_name": "SRIDHARA",
        "authorized_official_middle_name": "K S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-549-1294",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "C42391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.