MEDICARE: SATAR MEDICAL GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	A33919	CA

General Provider Information

NPI Number	:	1962958082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SATAR MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	713 ONE AND HALF N RIDGEWOOD PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038
Country	:	US
Telephone Number	:	323-464-1550
Fax Number	:	323-464-1557

Provider Business Practice Location Address
First Line	:	713 ONE AND HALF N RIDGEWOOD PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90038-3105
Country	:	US
Telephone Number	:	323-464-1550
Fax Number	:	323-464-1557

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. YOUSEF MEHRABI
Credential	:	M.D.
Telephone Number	:	323-464-1550

Provider Enumeration Date	:	08/29/2016
Last Update Date	:	08/29/2016

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