Healthcare Provider Details

I. General information

NPI: 1447891924
Provider Name (Legal Business Name): NADER SOBH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2019
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 N LA BREA AVE STE 3
LOS ANGELES CA
90028-7565
US

IV. Provider business mailing address

1335 N LA BREA AVE STE 3
LOS ANGELES CA
90028-7565
US

V. Phone/Fax

Practice location:
  • Phone: 818-696-0091
  • Fax:
Mailing address:
  • Phone: 951-833-3712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NADER SOBH
Title or Position: PHYSICIAN
Credential: DO
Phone: 951-833-3712