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General NPI Number Information
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NPI Number | 1992816193
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Entity Type | Individual
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Provider Name | SOTERO FESTIN FABELLA MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1905 MCDANIEL ST STE 102
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030
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Country | US
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Telephone | 702-649-1980
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Fax | 702-642-2930
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Provider Business Mailing Address
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Address Line | 1905 MCDANIEL ST STE 102
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89030
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Country | US
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Telephone | 702-649-1980
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Fax | 702-642-2930
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | NV4047
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License Number State | NV
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