Healthcare Provider Details

I. General information

NPI: 1356703995
Provider Name (Legal Business Name): SARATHI BHATTACHARYYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3828 SCHAUFELE AVE, STE. 200
LONG BEACH CA
90808
US

IV. Provider business mailing address

3828 SCHAUFELE AVE, STE. 200
LONG BEACH CA
90808
US

V. Phone/Fax

Practice location:
  • Phone: 657-241-8990
  • Fax: 714-665-4664
Mailing address:
  • Phone: 657-241-8990
  • Fax: 714-665-4664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA151469
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number151469
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberA151469
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA151469
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: