MEDICARE: SARBAB INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1013664838
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARBAB INC

Provider Business Mailing Address
First Line	:	6907 LANKERSHIM BLVD
Second Line	:
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91605-6111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6907 LANKERSHIM BLVD
Second Line	:
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91605-6111
Country	:	US
Telephone Number	:	818-731-4021
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IVANN WILLIAM DEOCAM MUSCAT
Credential	:
Telephone Number	:	818-731-4021

Provider Enumeration Date	:	03/02/2022
Last Update Date	:	03/02/2022

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Directions to “SARBAB INC ” Practice Location

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