MEDICARE: DR. ELIZABETH KLINE SATTER MD, MPH, MSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	37672	GA
2	207N00000X	Dermatology Physician	98919	CA
3	207ND0900X	Dermatopathology Physician	A98919	CA
4	207ND0900X	Dermatopathology Physician	037672	GA
5	207N00000X	Dermatology Physician	A98919	CA

General Provider Information

NPI Number	:	1164493151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH KLINE SATTER MD, MPH, MSC

Provider Business Mailing Address
First Line	:	2565 INGULF PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-2361
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2565 INGULF PLACE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92110
Country	:	US
Telephone Number	:	619-446-1971
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	02/16/2022

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