Healthcare Provider Details

I. General information

NPI: 1558681247
Provider Name (Legal Business Name): FARIBORZ DAVID SATEY, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44215 NORTH 15TH STREET WEST SUITE 115
LANCASTER CA
93534-5503
US

IV. Provider business mailing address

627 WEST AVENUE Q SUITE D
PALMDALE CA
93551-3891
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-5929
  • Fax: 661-949-5083
Mailing address:
  • Phone: 661-272-5656
  • Fax: 661-272-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA53170
License Number StateCA

VIII. Authorized Official

Name: DR. FARIBORZ DAVID SATEY
Title or Position: OWNER
Credential: M.D.
Phone: 661-272-5656