Provider Demographics
NPI:1770725731
Name:SABETI CHIROPRACTIC INC.
Entity type:Organization
Organization Name:SABETI CHIROPRACTIC INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:FARANGIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SABETI-KOLAHI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-680-3377
Mailing Address - Street 1:PO BOX 1377
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92609-1377
Mailing Address - Country:US
Mailing Address - Phone:949-680-3377
Mailing Address - Fax:949-680-3378
Practice Address - Street 1:22762 ASPAN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1604
Practice Address - Country:US
Practice Address - Phone:949-680-3377
Practice Address - Fax:949-680-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU90568Medicare UPIN