Healthcare Provider Details

I. General information

NPI: 1760902522
Provider Name (Legal Business Name): SATISH R VADAPALLI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2017
Last Update Date: 03/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 SILLECT AVE STE 100
BAKERSFIELD CA
93308-6360
US

IV. Provider business mailing address

7230 MEDICAL CENTER DR STE 501
WEST HILLS CA
91307-4029
US

V. Phone/Fax

Practice location:
  • Phone: 661-381-7222
  • Fax: 661-846-2447
Mailing address:
  • Phone: 818-348-7253
  • Fax: 818-348-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberG871757
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberG81757
License Number StateCA

VIII. Authorized Official

Name: CHRISTOPHER S CARMONA
Title or Position: CHIEF OPERATION OFFICER
Credential:
Phone: 818-348-7253