Provider Demographics
NPI:1194889675
Name:MULTANI, SATPAL SINGH (OD)
Entity type:Individual
Prefix:DR
First Name:SATPAL
Middle Name:SINGH
Last Name:MULTANI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:473 E CARNEGIE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-4207
Mailing Address - Country:US
Mailing Address - Phone:909-884-1838
Mailing Address - Fax:909-884-0865
Practice Address - Street 1:473 E CARNEGIE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-4207
Practice Address - Country:US
Practice Address - Phone:909-884-1838
Practice Address - Fax:909-884-0865
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10385 T152WC0802X, 152WL0500X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0103851Medicaid
CASD0103850Medicare ID - Type UnspecifiedMEDICARE NUMBER