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General NPI Number Information
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NPI Number | 1568679397
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Entity Type | Organization
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Legal Business Name | SABLAN MEDICAL CORPORATION
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 979 O ST STE B
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City | FIREBAUGH
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State | CA
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Zip | 93622-2220
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Country | US
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Telephone | 559-296-5080
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Fax | 559-296-5011
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | FIREBAUGH
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State | CA
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Zip | 93622-0306
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Country | US
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Telephone | 559-296-5080
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Fax | 559-296-5011
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Authorized Official
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Title or Position | PRESIDENT
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Name | OSCAR M SABLAN
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Credential | M.D.
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Telephone | 559-296-5080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G45421
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G45391
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | G45421
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License Number State | CA
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