Provider Demographics
NPI:1669454898
Name:SABEN, LAURENCE ROSS (MD)
Entity Type:Individual
Prefix:
First Name:LAURENCE
Middle Name:ROSS
Last Name:SABEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9939 HIBERT ST STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1031
Mailing Address - Country:US
Mailing Address - Phone:619-440-7831
Mailing Address - Fax:619-440-0540
Practice Address - Street 1:9939 HIBERT ST STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1031
Practice Address - Country:US
Practice Address - Phone:619-440-7831
Practice Address - Fax:619-440-0540
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-15
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG274462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G274461Medicaid
CA000G274461Medicaid
G27446Medicare ID - Type Unspecified