MEDICARE: TAMARA SATTERWHITE

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	171W00000X	Contractor

General Provider Information

NPI Number	:	1538282181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA SATTERWHITE

Provider Business Mailing Address
First Line	:	711 S NEW HAMPSHIRE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90005-1831
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5314 PACKARD ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-2650
Country	:	US
Telephone Number	:	323-935-0618
Fax Number	:

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	07/08/2007

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Directions to “ TAMARA SATTERWHITE ” Practice Location

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