Healthcare Provider Details

I. General information

NPI: 1457307530
Provider Name (Legal Business Name): SABAH N CHAMMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 ENCINITAS BLVD SUITE#100
ENCINITAS CA
92024-8704
US

IV. Provider business mailing address

PO BOX 609001
SAN DIEGO CA
92160-9001
US

V. Phone/Fax

Practice location:
  • Phone: 619-528-4600
  • Fax: 619-528-4625
Mailing address:
  • Phone: 619-528-4600
  • Fax: 619-528-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC37866
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: