Provider Demographics
NPI:1932556859
Name:SABINO, AMBAR
Entity Type:Individual
Prefix:
First Name:AMBAR
Middle Name:
Last Name:SABINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5846 GREGORY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-3908
Mailing Address - Country:US
Mailing Address - Phone:978-943-4664
Mailing Address - Fax:
Practice Address - Street 1:5846 GREGORY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-3908
Practice Address - Country:US
Practice Address - Phone:978-943-4664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator