Basic Information
| Provider Information | |||||||||
| NPI: | 1700330479 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLOMBEAU | ||||||||
| FirstName: | SABINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 521 FLOOD AVE | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941121336 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152391825 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3435 CAMINO DEL RIO S | ||||||||
| Address2: | SUITE 219 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921083902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8772646747 | ||||||||
| FaxNumber: | 8775397730 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2016 | ||||||||
| LastUpdateDate: | 08/10/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | RBT-16-21237 | CA | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Other |
No ID Information.