Healthcare Provider Details

I. General information

NPI: 1902245616
Provider Name (Legal Business Name): SABA FARANAZ-KABIR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79430 HIGHWAY 111 STE 102
LA QUINTA CA
92253-4549
US

IV. Provider business mailing address

79430 HIGHWAY 111 STE 102
LA QUINTA CA
92253-4549
US

V. Phone/Fax

Practice location:
  • Phone: 844-827-8000
  • Fax:
Mailing address:
  • Phone: 844-827-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number267981
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: