Provider Demographics
NPI:1558533000
Name:MOORE-COHEN, SABINA BERKELEY (MD)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:BERKELEY
Last Name:MOORE-COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SABINA
Other - Middle Name:BERKELEY
Other - Last Name:KUHNT-MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1805 MEDICAL CENTER DR
Mailing Address - Street 2:MEDICAL STAFF OFFICE
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92411-1217
Mailing Address - Country:US
Mailing Address - Phone:909-806-1598
Mailing Address - Fax:
Practice Address - Street 1:1805 MEDICAL CENTER DR
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1217
Practice Address - Country:US
Practice Address - Phone:909-806-1598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102962207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAQ088WMedicare PIN