Provider Demographics
NPI:1073834164
Name:SAMUEL SABO DO
Entity Type:Organization
Organization Name:SAMUEL SABO DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SABO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:503-655-6044
Mailing Address - Street 1:18171 WALDOW RD
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-8818
Mailing Address - Country:US
Mailing Address - Phone:503-655-6044
Mailing Address - Fax:503-575-9171
Practice Address - Street 1:18171 WALDOW RD
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-8818
Practice Address - Country:US
Practice Address - Phone:503-655-6044
Practice Address - Fax:503-575-9171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-12
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO08518261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care