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General NPI Number Information
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NPI Number | 1033393467
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Entity Type | Organization
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Legal Business Name | BRUCE SAHBA MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/20/2007
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 3865 CLAIREMONT DR
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City | SAN DIEGO
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State | CA
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Zip | 92117-5831
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Country | US
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Telephone | 858-272-2300
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Fax | 858-272-2340
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Provider Business Mailing Address
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Address Line | 3865 CLAIREMONT DR
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City | SAN DIEGO
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State | CA
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Zip | 92117-5831
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Country | US
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Telephone | 858-272-2300
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Fax | 858-272-2340
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Authorized Official
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Title or Position | BILLER
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Name | MR. RICHARD F FLAKS
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Credential |
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Telephone | 619-660-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A31591
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License Number State | CA
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