Healthcare Provider Details

I. General information

NPI: 1134697196
Provider Name (Legal Business Name): SBH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2018
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17921 SKY PARK CIR STE A
IRVINE CA
92614
US

IV. Provider business mailing address

17921 SKY PARK CIR STE A
IRVINE CA
92614
US

V. Phone/Fax

Practice location:
  • Phone: 844-352-3552
  • Fax: 949-606-9052
Mailing address:
  • Phone: 844-352-3552
  • Fax: 949-606-9052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ANNALISA CHAVES
Title or Position: COO
Credential:
Phone: 310-467-2627