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NPI Code Detail

MEDICARE: MRS. ABIGAIL ABUYUAN SOBREPENA

MEDICARE:  MRS. ABIGAIL ABUYUAN SOBREPENA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1568749133
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ABIGAIL ABUYUAN SOBREPENA
Provider Business Mailing Address
First Line : 7100 GRAND MONTECITO PKWY
Second Line : UNIT 4067
City : LAS VEGAS
State : NV
Zip : 89149-0282
Country : US
Telephone Number : 702-672-6548
Fax Number :
Provider Business Practice Location Address
First Line : 7100 GRAND MONTECITO PKWY
Second Line : UNIT 4067
City : LAS VEGAS
State : NV
Zip : 89149-0282
Country : US
Telephone Number : 702-672-6548
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2011
Last Update Date : 11/17/2011

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