Healthcare Provider Details

I. General information

NPI: 1841560984
Provider Name (Legal Business Name): CARL SATTON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

24900 VALLEY BOULEVARD
TEHACHAPI CA
93561
US

IV. Provider business mailing address

24900 END OF HIGHWAY 202
TEHACHAPI CA
93561
US

V. Phone/Fax

Practice location:
  • Phone: 661-822-4402
  • Fax: 661-823-3354
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: