Healthcare Provider Details

I. General information

NPI: 1669202198
Provider Name (Legal Business Name): SAN DIEGO EYE AND FACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3399 1ST AVE
SAN DIEGO CA
92103-5601
US

IV. Provider business mailing address

3911 CLEVELAND AVE # 635175
SAN DIEGO CA
92103-3402
US

V. Phone/Fax

Practice location:
  • Phone: 858-284-0608
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KELLIE SATTERFIELD
Title or Position: PRESIDENT
Credential: MD
Phone: 541-301-0608