Provider Demographics
NPI:1205940111
Name:NOBEL, SION (MD)
Entity type:Individual
Prefix:
First Name:SION
Middle Name:
Last Name:NOBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4954 VAN NUYS BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1798
Mailing Address - Country:US
Mailing Address - Phone:818-361-0115
Mailing Address - Fax:818-361-9497
Practice Address - Street 1:10306 N SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345
Practice Address - Country:US
Practice Address - Phone:818-261-0115
Practice Address - Fax:818-361-9497
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38937208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16386Medicare PIN
CAA28764Medicare UPIN