Healthcare Provider Details

I. General information

NPI: 1053679472
Provider Name (Legal Business Name): SABRINA PERRINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 11/29/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E WALNUT STREET PASADENA CA 91188
PASADENA CA
91188-0001
US

IV. Provider business mailing address

393 E WALNUT STREET PASADENA CA 91188
PASADENA CA
91188-0001
US

V. Phone/Fax

Practice location:
  • Phone: 877-608-0044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number129805
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: