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General NPI Number Information
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NPI Number | 1588862106
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Entity Type | Organization
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Legal Business Name | JUAN PABLO FALABELLA , INC
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 1701 TRUMAN ST STE. B
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City | SAN FERNANDO
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State | CA
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Zip | 91340-3100
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Country | US
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Telephone | 818-837-1660
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Fax | 818-837-1662
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Provider Business Mailing Address
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Address Line | 1701 TRUMAN ST. STE. B
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City | SAN FERNANDO
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State | CA
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Zip | 91340
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Country | US
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Telephone | 818-837-1660
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Fax | 818-837-1662
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Authorized Official
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Title or Position | DENTIST
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Name | JUAN PABLO FALABELLA
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Credential | D.D.S
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Telephone | 818-837-1660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 49310
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License Number State | CA
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