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General NPI Number Information
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NPI Number | 1265463947
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Entity Type | Individual
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Provider Name | JUAN R SOBENES M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2615 E CLINTON AVE VA CENTRAL CALIFORNIA HEALTH CARE SYSTEM
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City | FRESNO
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State | CA
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Zip | 93703-2223
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Country | US
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Telephone | 559-225-6100
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Fax | 559-228-5369
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Provider Business Mailing Address
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Address Line | 2615 E CLINTON AVE VA CENTRAL CALIFORNIA HEALTH CARE SYSTEM
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City | FRESNO
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State | CA
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Zip | 93703-2223
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Country | US
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Telephone | 559-225-6100
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Fax | 559-228-5369
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Q00000X
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Taxonomy Name | Pathology Specialist/Technologist
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License Number | A23046
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License Number State | CA
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