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General NPI Number Information
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NPI Number | 1316206501
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Entity Type | Organization
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Legal Business Name | PY SADDLER, M.D., F.A.C.P., INC
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 1437 SAN MARINO AVE
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City | SAN MARINO
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State | CA
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Zip | 91108-2027
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Country | US
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Telephone | 626-405-1034
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Fax | 626-405-1036
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Provider Business Mailing Address
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Address Line | 1437 SAN MARINO AVE
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City | SAN MARINO
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State | CA
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Zip | 91108-2027
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Country | US
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Telephone | 626-405-1034
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Fax | 626-405-1036
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Authorized Official
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Title or Position | CEO
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Name | DR. PAULETTE YVONNE SADDLER
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Credential |
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Telephone | 626-405-1034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G59264
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License Number State | CA
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