Provider Demographics
NPI:1780693374
Name:SABATINI, JOHN R (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:SABATINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1360 W. SIXTH STREET
Mailing Address - Street 2:STE. 200
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:97032-3514
Mailing Address - Country:US
Mailing Address - Phone:310-547-9922
Mailing Address - Fax:310-547-4673
Practice Address - Street 1:2841 LOMITA BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-5105
Practice Address - Country:US
Practice Address - Phone:310-257-0508
Practice Address - Fax:310-325-8109
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG31402174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG31402MMedicare ID - Type Unspecified
CAWG31402OMedicare ID - Type Unspecified
CAWG31402DMedicare ID - Type Unspecified
CAA44759Medicare UPIN
CAWG31402LMedicare ID - Type Unspecified
CAWG31402PMedicare ID - Type Unspecified
CAWG31402NMedicare ID - Type Unspecified