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General NPI Number Information
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NPI Number | 1417138538
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Entity Type | Organization
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Legal Business Name | HOLLY SATA MD , PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 20201 SW BIRCH ST STE 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1781
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Country | US
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Telephone | 714-935-9500
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Fax | 714-935-9559
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Provider Business Mailing Address
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Address Line | 277 MORNING CANYON RD
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City | CORONA DEL MAR
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State | CA
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Zip | 92625-2641
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Country | US
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Telephone | 714-600-6760
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Fax | 949-720-0337
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. HOLLY SATA
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Credential | M.D.
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Telephone | 714-600-6760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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