1255445904 NPI number — SAYED SABEK MD

Table of content: SAYED SABEK MD (NPI 1255445904)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255445904 NPI number — SAYED SABEK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SABEK
Provider First Name:
SAYED
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SABEK
Provider Other First Name:
MICHAEL
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1255445904
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/27/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1013 E FERGUSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VISALIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93292-7202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-277-6197
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 N CHERRY ST
Provider Second Line Business Practice Location Address:
TULARE VA CLINIC
Provider Business Practice Location Address City Name:
TULARE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-684-8703
Provider Business Practice Location Address Fax Number:
559-248-5329
Provider Enumeration Date:
08/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  4301078618 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207P00000X , with the licence number: 35085073 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 4301078618 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0805610332 . This is a "BC BS OF MI" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2723940 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1255445904 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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