Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 102440 | MN |
NPI | 1063422459 |
---|---|
Provider Name | Airani Sathananthan |
First Address | Pomona, CA 91766 |
Second Address | Pomona, CA 91766-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 13/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CQ417Y | MEDICARE NORTHERN CALIFORNIA (01) | CA |
CQ417Z | MEDICARE SOUTHERN CALIFORNIA (01) | CA |
I58221 | (02) |