Provider Demographics
NPI:1932404597
Name:LILIAN E SABABA MD INC
Entity Type:Organization
Organization Name:LILIAN E SABABA MD INC
Other - Org Name:SALUD DE LA MUJER Y NINO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SABABA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-660-2100
Mailing Address - Street 1:866 N VERMONT AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-3587
Mailing Address - Country:US
Mailing Address - Phone:323-660-2100
Mailing Address - Fax:323-662-0078
Practice Address - Street 1:866 N VERMONT AVE STE 1
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-3587
Practice Address - Country:US
Practice Address - Phone:323-660-2100
Practice Address - Fax:323-662-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA48778208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF04446Medicare UPIN