Healthcare Provider Details

I. General information

NPI: 1376168492
Provider Name (Legal Business Name): NADER SOBH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2020
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 N ROBERTSON BLVD
BEVERLY HILLS CA
90211-2103
US

IV. Provider business mailing address

716 W BROADWAY STE 200
GLENDALE CA
91204-1010
US

V. Phone/Fax

Practice location:
  • Phone: 951-833-3712
  • Fax:
Mailing address:
  • Phone: 818-696-0091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NADER SOBH
Title or Position: PHYSICIAN
Credential: DO
Phone: 951-833-3712