Healthcare Provider Details

I. General information

NPI: 1598786055
Provider Name (Legal Business Name): LEWIS M. SATLOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 S RANCHO SAHUARITA BLVD
SAHUARITA AZ
85629-0047
US

IV. Provider business mailing address

363 N DETROIT ST
LOS ANGELES CA
90036-2530
US

V. Phone/Fax

Practice location:
  • Phone: 520-416-7100
  • Fax:
Mailing address:
  • Phone: 239-222-1474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG65170
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberG65170
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number17470
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: