=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295899441
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. RUBEN VICENTE SARABIA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 333 WHITEROCK DR
-----------------------------------------------------
City | YUBA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95991-8244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-673-3364
-----------------------------------------------------
Fax | 530-674-1381
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 333 WHITEROCK DR
-----------------------------------------------------
City | YUBA CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95991-8244
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-673-3364
-----------------------------------------------------
Fax | 530-674-1381
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number | 66471
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------