Provider Demographics
NPI:1417153404
Name:LAURENCE R. SABEN, M.D. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:LAURENCE R. SABEN, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:SABEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-440-7831
Mailing Address - Street 1:615 E LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-4617
Mailing Address - Country:US
Mailing Address - Phone:619-440-7831
Mailing Address - Fax:619-440-0540
Practice Address - Street 1:615 E LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-4617
Practice Address - Country:US
Practice Address - Phone:619-440-7831
Practice Address - Fax:619-440-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG274462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G274461Medicaid
CAU91052Medicare UPIN