Provider Demographics
NPI:1326263575
Name:SATTLER, JON INMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:INMAN
Last Name:SATTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W. CARROLL AVENUE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741
Mailing Address - Country:US
Mailing Address - Phone:626-335-0900
Mailing Address - Fax:626-335-0933
Practice Address - Street 1:412 W. CARROLL AVENUE
Practice Address - Street 2:SUITE 103
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741
Practice Address - Country:US
Practice Address - Phone:626-335-0900
Practice Address - Fax:626-335-0933
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC511612086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC51161OtherMEDICAL LICENSE
CABS8289349OtherDEA NO.