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General NPI Number Information
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NPI Number | 1245525690
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Entity Type | Individual
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Provider Name | MAHENDRA G SANATHRA MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 2015 E. FLORENCE AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90001-2754
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Country | US
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Telephone | 323-581-0000
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Fax | 323-585-4030
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Provider Business Mailing Address
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Address Line | 2015 E. FLORENCE AVE.
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City | LOS ANGELES
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State | CA
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Zip | 90001-2754
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Country | US
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Telephone | 323-581-0000
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Fax | 323-585-4030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | A50182
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A50182
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License Number State | CA
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