Healthcare Provider Details

I. General information

NPI: 1003760356
Provider Name (Legal Business Name): ANTOINE SABA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2026
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2279 EAGLE GLEN PKWY STE 110
CORONA CA
92883-0790
US

IV. Provider business mailing address

4107 ADISHIAN WAY
CORONA CA
92883-0723
US

V. Phone/Fax

Practice location:
  • Phone: 951-268-6550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number95235639
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: