Provider Demographics
NPI:1023383049
Name:QUALITY CARE FAMILY PRACTICE
Entity Type:Organization
Organization Name:QUALITY CARE FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANURADHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SATHYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-833-1429
Mailing Address - Street 1:PO BOX 77086
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92877-0102
Mailing Address - Country:US
Mailing Address - Phone:714-833-1429
Mailing Address - Fax:951-639-3786
Practice Address - Street 1:2083 COMPTON AVE
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-7283
Practice Address - Country:US
Practice Address - Phone:714-833-1429
Practice Address - Fax:951-639-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty