Provider Demographics
NPI:1912362567
Name:SANJOY SATHPATHY, M.D. INC,
Entity Type:Organization
Organization Name:SANJOY SATHPATHY, M.D. INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJOY
Authorized Official - Middle Name:
Authorized Official - Last Name:SATHPATHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-960-1848
Mailing Address - Street 1:PO BOX 712668
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92171-2668
Mailing Address - Country:US
Mailing Address - Phone:619-294-4119
Mailing Address - Fax:619-295-5044
Practice Address - Street 1:9888 CARROLL CENTER ROAD
Practice Address - Street 2:218
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4515
Practice Address - Country:US
Practice Address - Phone:858-935-9104
Practice Address - Fax:858-935-9103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA801952084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA80195OtherCALIFORNIA MEDICAL LICENSE