Healthcare Provider Details

I. General information

NPI: 1972709665
Provider Name (Legal Business Name): JONATHAN D SORBELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28765 SINGLE OAK DR STE 100
TEMECULA CA
92590-3661
US

IV. Provider business mailing address

28765 SINGLE OAK DR STE 100
TEMECULA CA
92590-3661
US

V. Phone/Fax

Practice location:
  • Phone: 530-601-8459
  • Fax:
Mailing address:
  • Phone: 805-801-9732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: