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General NPI Number Information
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NPI Number | 1568470854
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Entity Type | Organization
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Legal Business Name | PABLO SOBERO MD INC
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 24430 ALESSANDRO BLVD SUITE 103
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City | MORENO VALLEY
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State | CA
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Zip | 92553-2435
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Country | US
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Telephone | 951-485-8490
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Fax | 951-485-8004
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Provider Business Mailing Address
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Address Line | 24430 ALESSANDRO BLVD SUITE 103
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City | MORENO VALLEY
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State | CA
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Zip | 92553-2435
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Country | US
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Telephone | 951-485-8490
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Fax | 951-485-8004
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | PABLO SOBERO
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Credential |
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Telephone | 951-485-8490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | A85824
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License Number State | CA
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