| Soulphysio Lifestyle | |
|
17805 Sky Park Cir Ste F Irvine CA 92614-6108 | |
| (949) 418-7956 | |
| Not Available |
| Full Name | Soulphysio Lifestyle |
|---|---|
| Speciality | Clinic/Center |
| Location | 17805 Sky Park Cir Ste F, Irvine, California |
| Authorized Official Name and Position | Aneesh Chaudhry (OWNER) |
| Authorized Official Contact | 9494187956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulphysio Lifestyle 17805 Sky Park Cir Ste F Irvine CA 92614-6108 Ph: (949) 418-7956 | Soulphysio Lifestyle 17805 Sky Park Cir Ste F Irvine CA 92614-6108 Ph: (949) 418-7956 |
| NPI Number | 1710653589 |
|---|---|
| Provider Enumeration Date | 08/20/2021 |
| Last Update Date | 08/27/2021 |
| Medicare PECOS PAC ID | 2668879958 |
|---|---|
| Medicare Enrollment ID | O20210929002713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710653589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Arvinderpaul Sarai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811957418 PECOS PAC ID: 7911943774 Enrollment ID: I20130807000606 |
| Provider Name | Madhuri Kasireddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770986424 PECOS PAC ID: 8224375936 Enrollment ID: I20190415000825 |
| Provider Name | Sarah Marie Jackson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821506320 PECOS PAC ID: 9739571068 Enrollment ID: I20220119001737 |
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