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General NPI Number Information
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NPI Number | 1669279691
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Entity Type | Individual
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Provider Name | KEVIN BRENT SABLICH NP
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Gender | Male
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 435 H ST
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City | CHULA VISTA
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State | CA
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Zip | 91910-4307
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Country | US
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Telephone | 619-691-7360
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Fax |
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Provider Business Mailing Address
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Address Line | 10353 SAN DIEGO MISSION RD APT C202
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City | SAN DIEGO
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State | CA
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Zip | 92108-2152
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Country | US
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Telephone | 267-709-8964
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 95034021
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License Number State | CA
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