Provider Demographics
NPI:1720117492
Name:MONA I SARBU
Entity Type:Organization
Organization Name:MONA I SARBU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONA
Authorized Official - Middle Name:I
Authorized Official - Last Name:SARBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-899-7090
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:530-899-7090
Practice Address - Fax:530-899-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87908207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0052OtherMEDICARE RAILROAD #
CAGR0101470Medicaid
CAZZZ02913ZMedicare PIN
CAGR0101470Medicaid