Provider Demographics
NPI:1790440519
Name:NADER SOBH INC
Entity Type:Organization
Organization Name:NADER SOBH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-833-3712
Mailing Address - Street 1:1222 N KINGS RD APT 9
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-2865
Mailing Address - Country:US
Mailing Address - Phone:951-833-3712
Mailing Address - Fax:
Practice Address - Street 1:1335 N LA BREA AVE STE 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-7565
Practice Address - Country:US
Practice Address - Phone:951-833-3712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NADER SOBH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty