Provider Demographics
NPI:1508998329
Name:SENTENN, GREGG A (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGG
Middle Name:A
Last Name:SENTENN
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 1:1626 WARDMAN DR
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-1849
Mailing Address - Country:US
Mailing Address - Phone:714-990-2006
Mailing Address - Fax:714-990-9201
Practice Address - Street 1:3350 E BIRCH ST
Practice Address - Street 2:STE. 100
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6264
Practice Address - Country:US
Practice Address - Phone:714-528-9335
Practice Address - Fax:714-528-9630
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2010-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG274522084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43358Medicare UPIN