Provider Demographics
NPI:1538483995
Name:SOBING, NOEL ELATICO (RN)
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:ELATICO
Last Name:SOBING
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5767 W CENTURY BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1260 15TH ST STE 1200
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1147
Practice Address - Country:US
Practice Address - Phone:424-259-7909
Practice Address - Fax:424-259-7943
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA688552163W00000X
CA23570363LC0200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAES322AOtherMEDICARE ID #