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NPI Code Detail

MEDICARE: PABLO SOBERO MD INC

MEDICARE: PABLO SOBERO MD INC
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
1173000000XLegal MedicineA85824CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568470854
Entity Type Code : Organization
Provider Name (Legal Business Name) : PABLO SOBERO MD INC
Provider Business Mailing Address
First Line : 24430 ALESSANDRO BLVD
Second Line : SUITE 103
City : MORENO VALLEY
State : CA
Zip : 92553-2435
Country : US
Telephone Number : 951-485-8490
Fax Number : 951-485-8004
Provider Business Practice Location Address
First Line : 24430 ALESSANDRO BLVD
Second Line : SUITE 103
City : MORENO VALLEY
State : CA
Zip : 92553-2435
Country : US
Telephone Number : 951-485-8490
Fax Number : 951-485-8004
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : PABLO SOBERO
Credential :
Telephone Number : 951-485-8490
Provider Enumeration Date : 08/03/2006
Last Update Date : 03/07/2013

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Directions to “PABLO SOBERO MD INC ” Practice Location

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