Provider Demographics
NPI:1518148592
Name:SATNAM S. UPPAL, MD INC
Entity Type:Organization
Organization Name:SATNAM S. UPPAL, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SATNAM
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:UPPAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-722-8047
Mailing Address - Street 1:650 W OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-2423
Mailing Address - Country:US
Mailing Address - Phone:209-722-8047
Mailing Address - Fax:209-722-1358
Practice Address - Street 1:650 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-2423
Practice Address - Country:US
Practice Address - Phone:209-722-8047
Practice Address - Fax:209-722-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31940207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ97294ZMedicare PIN
CAA26647Medicare UPIN