Healthcare Provider Details

I. General information

NPI: 1588701155
Provider Name (Legal Business Name): DAVID MICHAEL CABRAL CST , ASC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 N ARLINGTON AVE STE 655
RENO NV
89503-4444
US

IV. Provider business mailing address

2457 HIBERNICA LN
SPARKS NV
89436-9185
US

V. Phone/Fax

Practice location:
  • Phone: 775-333-5555
  • Fax:
Mailing address:
  • Phone: 775-626-7448
  • Fax: 775-287-0144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: