Provider Demographics
NPI:1639282015
Name:SATNICK, WILLIAM (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:SATNICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12880 RANCHO PENASQUITOS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2966
Mailing Address - Country:US
Mailing Address - Phone:858-484-2000
Mailing Address - Fax:858-484-3414
Practice Address - Street 1:12880 RANCHO PENASQUITOS BLVD STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2966
Practice Address - Country:US
Practice Address - Phone:858-484-2000
Practice Address - Fax:858-484-3414
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGY681AMedicare PIN