Healthcare Provider Details

I. General information

NPI: 1356489629
Provider Name (Legal Business Name): FARIBORZ DAVID SATEY M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 661-272-5656
  • Fax: 661-272-0909
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 Number
License Number State

VIII. Authorized Official

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