Basic Information
| Provider Information | |||||||||
| NPI: | 1841590353 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SABU | ||||||||
| FirstName: | SEEMA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1190 SPRING CREEK PL | ||||||||
| Address2: | STE E1 | ||||||||
| City: | SPRINGVILLE | ||||||||
| State: | UT | ||||||||
| PostalCode: | 846636002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8018222234 | ||||||||
| FaxNumber: | 8558941638 | ||||||||
| Practice Location | |||||||||
| Address1: | 1020 TIJERAS AVE NE STE 22 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871064749 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5057271670 | ||||||||
| FaxNumber: | 5057279590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2010 | ||||||||
| LastUpdateDate: | 11/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA2010-0047 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.