Provider Demographics
NPI:1043213523
Name:SABIN, ADRIENNE CYGAL (DPM)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:CYGAL
Last Name:SABIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5327 HOUNDS EST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95135-1207
Mailing Address - Country:US
Mailing Address - Phone:408-275-9200
Mailing Address - Fax:
Practice Address - Street 1:5327 HOUNDS EST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95135-1207
Practice Address - Country:US
Practice Address - Phone:408-275-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-27
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3393213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0243220001Medicare NSC