Provider Demographics
NPI:1003021965
Name:SATISH S. KADABA, M.D., INC.
Entity Type:Organization
Organization Name:SATISH S. KADABA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:S
Authorized Official - Last Name:KADABA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-264-6296
Mailing Address - Street 1:4545 E 3RD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-1656
Mailing Address - Country:US
Mailing Address - Phone:323-264-6296
Mailing Address - Fax:323-264-6297
Practice Address - Street 1:4545 E 3RD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-1656
Practice Address - Country:US
Practice Address - Phone:323-264-6296
Practice Address - Fax:323-264-6297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X, 111N00000X, 171100000X, 207R00000X, 208100000X, 208VP0014X
CAA39716207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty