Provider Demographics
NPI:1982603718
Name:SAVITT, MARIA LOURDES DE FATIMA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:LOURDES DE FATIMA
Last Name:SAVITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26800 CROWN VALLEY PKWY STE 315
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-8039
Mailing Address - Country:US
Mailing Address - Phone:949-364-6000
Mailing Address - Fax:510-879-9086
Practice Address - Street 1:26800 CROWN VALLEY PKWY STE 315
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-8039
Practice Address - Country:US
Practice Address - Phone:949-364-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG132070207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04532206OtherBLUE CROSS BLUE SHIELD
ILK11512Medicare PIN
ILK11511Medicare PIN
ILP00202651Medicare PIN
ILF69339Medicare UPIN
IL036086162Medicaid