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General NPI Number Information
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NPI Number | 1467638668
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Entity Type | Organization
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Legal Business Name | OMAR B CABAHUG MD PROF CORP
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 2500 WIGWAM PKWY SUITE 112
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City | HENDERSON
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State | NV
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Zip | 89074-7112
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Country | US
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Telephone | 702-914-6994
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Fax | 702-914-5880
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Provider Business Mailing Address
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Address Line | 2500 WIGWAM PKWY SUITE 112
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City | HENDERSON
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State | NV
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Zip | 89074-7112
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Country | US
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Telephone | 702-914-6994
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Fax | 702-914-5880
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. OMAR B CABAHUG
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Credential | M.D.
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Telephone | 702-914-6994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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