Provider Demographics
NPI:1730293135
Name:SABATINI, WILLIAM LEROY (CRNA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:LEROY
Last Name:SABATINI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 E PALM AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-6273
Mailing Address - Country:US
Mailing Address - Phone:561-703-1003
Mailing Address - Fax:
Practice Address - Street 1:647 E PALM AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-6273
Practice Address - Country:US
Practice Address - Phone:561-703-1003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA812332367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306154000Medicaid
FL306154000Medicaid