Provider Demographics
NPI:1588857536
Name:SABRI E. SEN, M.D., INC.
Entity Type:Organization
Organization Name:SABRI E. SEN, M.D., INC.
Other - Org Name:ANTIOCH UROLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SABRI
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-812-4431
Mailing Address - Street 1:3903 LONE TREE WAY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:612-812-4431
Mailing Address - Fax:
Practice Address - Street 1:3903 LONE TREE WAY
Practice Address - Street 2:SUITE 310
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:612-812-4431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52938208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1720043862OtherNPI