Provider Demographics
NPI:1609986439
Name:SATEY, FARIBORZ DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:FARIBORZ
Middle Name:DAVID
Last Name:SATEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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:93551-3891
Mailing Address - Country:US
Mailing Address - Phone:661-272-5656
Mailing Address - Fax:661-272-0909
Practice Address - Street 1:627 WEST AVENUE Q
Practice Address - Street 2:SUITE D
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3891
Practice Address - Country:US
Practice Address - Phone:661-272-5656
Practice Address - Fax:661-272-0909
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53170208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A531700Medicaid
CAF96662Medicare UPIN