Provider Demographics
NPI:1750586723
Name:DR. SATPAL MULTANI, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DR. SATPAL MULTANI, A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SATPAL
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:MULTANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-884-1838
Mailing Address - Street 1:473 E CARNEGIE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3567
Mailing Address - Country:US
Mailing Address - Phone:909-884-1838
Mailing Address - Fax:909-884-0865
Practice Address - Street 1:473 E CARNEGIE DR STE 100
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3567
Practice Address - Country:US
Practice Address - Phone:909-884-1838
Practice Address - Fax:909-884-0865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0103851Medicaid
CASD0103852Medicare Oscar/Certification
CA4333520001Medicare NSC