Provider Demographics
NPI:1679647580
Name:SATIA, JAGAT BHUSHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAGAT
Middle Name:BHUSHAN
Last Name:SATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:229 FORRESTER RD
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-6508
Mailing Address - Country:US
Mailing Address - Phone:408-221-9062
Mailing Address - Fax:408-645-6542
Practice Address - Street 1:229 FORRESTER RD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-6508
Practice Address - Country:US
Practice Address - Phone:408-221-9062
Practice Address - Fax:408-645-6542
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA26473207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A264730Medicare ID - Type UnspecifiedPROVIDER NUMBER