Healthcare Provider Details

I. General information

NPI: 1811297427
Provider Name (Legal Business Name): ANGELA W SABRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 02/28/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 E CHAMPLAIN DR STE A
FRESNO CA
93720-4223
US

IV. Provider business mailing address

2021 HERNDON AVE STE 201
FRESNO CA
93611-6317
US

V. Phone/Fax

Practice location:
  • Phone: 559-494-4446
  • Fax: 559-494-4446
Mailing address:
  • Phone: 559-494-4446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberA117534
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number51467
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberA117534
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: