Provider Demographics
NPI:1831179845
Name:SABINO, ALAN D (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:SABINO
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 1:5330 SAINT ANDREWS DR
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-1914
Mailing Address - Country:US
Mailing Address - Phone:951-990-0550
Mailing Address - Fax:
Practice Address - Street 1:525 W ACACIA ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203-2405
Practice Address - Country:US
Practice Address - Phone:209-461-3109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77362207L00000X
OH35084776207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2490237Medicaid
OH2490237Medicaid
OHI09906Medicare UPIN