Provider Demographics
NPI:1760902522
Name:SATISH R VADAPALLI MD INC
Entity Type:Organization
Organization Name:SATISH R VADAPALLI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARMONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-348-7253
Mailing Address - Street 1:7230 MEDICAL CENTER DR STE 501
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-4029
Mailing Address - Country:US
Mailing Address - Phone:818-348-7253
Mailing Address - Fax:818-348-7012
Practice Address - Street 1:3008 SILLECT AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6360
Practice Address - Country:US
Practice Address - Phone:661-381-7222
Practice Address - Fax:661-846-2447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81757207YP0228X
CAG871757207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric OtolaryngologyGroup - Single Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty