MEDICARE: DR. KATAYOUN SABETIAN MD

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	G074923	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	770434389	OTHER	CA	TAX ID

General Provider Information

NPI Number	:	1184714453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATAYOUN SABETIAN MD

Provider Business Mailing Address
First Line	:	2323 16TH ST STE 206
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-3453
Country	:	US
Telephone Number	:	661-322-4601
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 16TH ST STE 206
Second Line	:
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-3453
Country	:	US
Telephone Number	:	661-322-4601
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2006
Last Update Date	:	01/29/2009

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