Provider Demographics
NPI:1457675324
Name:JON I. SATTLER, M.D., INC.
Entity Type:Organization
Organization Name:JON I. SATTLER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:I
Authorized Official - Last Name:SATTLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-203-9000
Mailing Address - Street 1:PO BOX 1046
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-1046
Mailing Address - Country:US
Mailing Address - Phone:310-203-9000
Mailing Address - Fax:818-787-9553
Practice Address - Street 1:1500 S CENTRAL AVE
Practice Address - Street 2:SUITE 126
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2530
Practice Address - Country:US
Practice Address - Phone:310-203-9000
Practice Address - Fax:818-787-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51161208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty