Provider Demographics
NPI:1619481447
Name:SABAU, MARIA (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:SABAU
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 MURIETTA AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-4224
Mailing Address - Country:US
Mailing Address - Phone:617-653-5623
Mailing Address - Fax:
Practice Address - Street 1:4251 MURIETTA AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-4224
Practice Address - Country:US
Practice Address - Phone:617-653-5623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54349363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAMS1072381JOtherCONTROLLED SUBSTANCE REGISTRATION
CA54349OtherPA LICENCE
MAPA6019OtherPA LICENSE
MAPA6019OtherPA LICENSE