Provider Demographics
NPI:1144331851
Name:SATHYA, RAAKESH (MD, MPH)
Entity type:Individual
Prefix:
First Name:RAAKESH
Middle Name:
Last Name:SATHYA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 E WALNUT ST
Mailing Address - Street 2:STE 120
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1451
Mailing Address - Country:US
Mailing Address - Phone:626-795-1831
Mailing Address - Fax:626-795-2716
Practice Address - Street 1:959 E WALNUT ST
Practice Address - Street 2:STE 120
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1451
Practice Address - Country:US
Practice Address - Phone:626-795-5118
Practice Address - Fax:626-795-2716
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088789207R00000X
CAC155272207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1144331851Medicaid