Provider Demographics
NPI:1295899441
Name:SARABIA, RUBEN VICENTE
Entity type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:VICENTE
Last Name:SARABIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WHITEROCK DR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-8244
Mailing Address - Country:US
Mailing Address - Phone:530-673-3364
Mailing Address - Fax:530-674-1381
Practice Address - Street 1:333 WHITEROCK DR
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-8244
Practice Address - Country:US
Practice Address - Phone:530-673-3364
Practice Address - Fax:530-674-1381
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA66471343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMTN01242FMedicaid