Provider Demographics
NPI:1346569472
Name:FARIBORZ DAVID SATEY, M.D., INC
Entity Type:Organization
Organization Name:FARIBORZ DAVID SATEY, M.D., INC
Other - Org Name:DR. SATEY'S PEDIATRIC & ADOLESCENT MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBORZ
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SATEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-272-5656
Mailing Address - Street 1:627 WEST AVENUE Q
Mailing Address - Street 2:SUITE D
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3891
Mailing Address - Country:US
Mailing Address - Phone:661-272-5656
Mailing Address - Fax:661-272-0909
Practice Address - Street 1:1707 WEST AVE J
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2703
Practice Address - Country:US
Practice Address - Phone:661-949-5929
Practice Address - Fax:661-949-5464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FARIBORZ DAVID SATEY, M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-05-28
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53170208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF96662Medicare UPIN