Provider Demographics
NPI:1174983688
Name:SABAH, MAIRA (DC)
Entity type:Individual
Prefix:
First Name:MAIRA
Middle Name:
Last Name:SABAH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6221 ARCADIA ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-4003
Mailing Address - Country:US
Mailing Address - Phone:310-971-0747
Mailing Address - Fax:
Practice Address - Street 1:17450 MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6262
Practice Address - Country:US
Practice Address - Phone:760-493-2929
Practice Address - Fax:760-493-2922
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33726111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor