Provider Demographics
NPI:1265500045
Name:SATNICK, STEVEN D (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:SATNICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14462 CALLEJON MUSICA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3817
Mailing Address - Country:US
Mailing Address - Phone:858-566-1756
Mailing Address - Fax:
Practice Address - Street 1:9460 MIRA MESA BLVD STE A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4870
Practice Address - Country:US
Practice Address - Phone:858-566-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9957-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist