Provider Demographics
NPI:1114496023
Name:SABIN, SCOTT MATHEW (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:MATHEW
Last Name:SABIN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 KERSHAWN PL
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7201
Mailing Address - Country:US
Mailing Address - Phone:760-522-2515
Mailing Address - Fax:
Practice Address - Street 1:3989 W STETSON AVE STE 105
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-9697
Practice Address - Country:US
Practice Address - Phone:951-652-3334
Practice Address - Fax:951-652-3335
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295798225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist