=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215069869
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STEVEN A. BATTAGLIA M.D. INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2007
-----------------------------------------------------
Last Update Date | 11/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 CONGRESS ST STE 103
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91105-3027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-796-6164
-----------------------------------------------------
Fax | 626-796-0883
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10 CONGRESS ST. STE. 103
-----------------------------------------------------
City | PASADENA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-796-6164
-----------------------------------------------------
Fax | 626-796-0883
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHYSICIAN
-----------------------------------------------------
Name | STEVEN A. BATTAGLIA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 626-796-6164
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | A78370
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------