Healthcare Provider Details

I. General information

NPI: 1689072795
Provider Name (Legal Business Name): SARAH BETH BOBNICK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH BETH ADEN

II. Dates (important events)

Enumeration Date: 12/05/2014
Last Update Date: 08/05/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MDG/SGGF 101 BODIN CIR
TRAVIS AFB CA
94535-1809
US

IV. Provider business mailing address

60 MDG/SGGF 101 BODIN CIR
TRAVIS AFB CA
94535-1809
US

V. Phone/Fax

Practice location:
  • Phone: 707-423-3057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberC2-0013445
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC2-0013445
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: