Provider Demographics
NPI:1487003224
Name:NOEL E. SOBING
Entity Type:Organization
Organization Name:NOEL E. SOBING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:ELATICO
Authorized Official - Last Name:SOBING
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:626-716-7657
Mailing Address - Street 1:10152 STAR MAGNOLIA LN
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-7217
Mailing Address - Country:US
Mailing Address - Phone:626-716-7657
Mailing Address - Fax:
Practice Address - Street 1:10152 STAR MAGNOLIA LN
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-7217
Practice Address - Country:US
Practice Address - Phone:626-716-7657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-10
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23570261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAES322AOtherMEDICARE ID#