Provider Demographics
NPI:1043332653
Name:MANN, SATINDER K (MD)
Entity Type:Individual
Prefix:
First Name:SATINDER
Middle Name:K
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2007
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92837-0007
Mailing Address - Country:US
Mailing Address - Phone:714-895-1774
Mailing Address - Fax:714-758-1485
Practice Address - Street 1:1771 W ROMNEYA DR
Practice Address - Street 2:SUITE E
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1817
Practice Address - Country:US
Practice Address - Phone:714-895-1774
Practice Address - Fax:714-758-1485
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA35522174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA35522OtherSTATE LICENSE
CA00A35220Medicaid
CA00A35220Medicaid