Provider Demographics
NPI:1306964002
Name:SABNANI, SURESH HARIRAM (DO)
Entity type:Individual
Prefix:DR
First Name:SURESH
Middle Name:HARIRAM
Last Name:SABNANI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N ALMANSOR ST
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-1132
Mailing Address - Country:US
Mailing Address - Phone:626-689-9755
Mailing Address - Fax:
Practice Address - Street 1:1101 N ALMANSOR ST
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-1132
Practice Address - Country:US
Practice Address - Phone:626-689-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5845207Q00000X, 2083S0010X, 2083X0100X, 208D00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Not Answered2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Not Answered208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Not Answered208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine