MEDICARE: FABIO L CANDEBAT MOREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1023962644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FABIO L CANDEBAT MOREN

Provider Business Mailing Address
First Line	:	1440 N EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-1553
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 N EASTERN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89101-1553
Country	:	US
Telephone Number	:	702-475-4352
Fax Number	:	702-356-8971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2026
Last Update Date	:	02/21/2026

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Directions to “ FABIO L CANDEBAT MOREN ” Practice Location

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