Provider Demographics
NPI:1639250855
Name:SARBU, MONA I (MD)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:I
Last Name:SARBU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 CERES AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-5635
Mailing Address - Country:US
Mailing Address - Phone:530-899-7090
Mailing Address - Fax:530-899-2765
Practice Address - Street 1:3011 CERES AVE
Practice Address - Street 2:STE 100
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-5635
Practice Address - Country:US
Practice Address - Phone:530-898-1201
Practice Address - Fax:530-899-2765
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A879080207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0052OtherMEDICARE RAILROAD #
CA00A879080Medicaid
DE0052OtherMEDICARE RAILROAD #
CA00A879080Medicaid