Provider Demographics
NPI:1972541886
Name:SARTI, DENNIS A (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:A
Last Name:SARTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 COTNER AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-3303
Mailing Address - Country:US
Mailing Address - Phone:310-445-2951
Mailing Address - Fax:310-479-1459
Practice Address - Street 1:1516 COTNER AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-3303
Practice Address - Country:US
Practice Address - Phone:310-445-2800
Practice Address - Fax:310-445-2983
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG194092085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G194090Medicaid
CAGR 0106039Medicaid
CA00G194090OtherBLUE SHIELD
CA00G194090Medicaid
CAWG19409AAMedicare PIN
CAWG19409EEMedicare PIN
CAWG19409KKMedicare PIN
CA00G194095Medicare PIN
CA00G194094Medicare PIN
CAWG19409UMedicare PIN
CAWG19409WMedicare PIN
CAAO723ZMedicare PIN
CAGR 0106039Medicaid
CAWG19409LLMedicare PIN
CAAT279YMedicare PIN
CAWG19409VMedicare PIN
CAWG19409IIMedicare PIN
CAWG19409MMMedicare PIN
CAWG19409SMedicare PIN
CAWG19409YMedicare PIN
CA00G194090Medicare PIN
CAWG19409JJMedicare PIN
CAAO723YMedicare PIN
CAWG19409GGMedicare PIN