Healthcare Provider Details

I. General information

NPI: 1972523769
Provider Name (Legal Business Name): SATHYA PRATAP POKALA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8031 LINDA VISTA RD STE 100
SAN DIEGO CA
92111-5110
US

IV. Provider business mailing address

8031 LINDA VISTA RD STE 100
SAN DIEGO CA
92111-5110
US

V. Phone/Fax

Practice location:
  • Phone: 619-644-9315
  • Fax: 619-644-9318
Mailing address:
  • Phone: 619-644-9315
  • Fax: 619-644-9318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA51070
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA51070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: