Provider Demographics
NPI:1881782290
Name:SARABIA, ESTEBAN (PAC)
Entity type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:
Last Name:SARABIA
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8412 LA SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-1222
Mailing Address - Country:US
Mailing Address - Phone:562-693-1827
Mailing Address - Fax:213-893-1967
Practice Address - Street 1:311 WINSTON ST
Practice Address - Street 2:LOS ANGELES MISSION COMMUNITY CLINIC
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-1519
Practice Address - Country:US
Practice Address - Phone:213-893-1960
Practice Address - Fax:213-893-1967
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA16600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEAP70948FOtherEAPC
CACMM70948FMedicaid
CAW15977Medicare ID - Type Unspecified
CACMM70948FMedicaid