MEDICARE: WENCESLAO CABALUNA MD

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
1	208600000X	Surgery Physician	7052	NV

General Provider Information

NPI Number	:	1902904600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENCESLAO CABALUNA MD

Provider Business Mailing Address
First Line	:	150 E HARMON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-4533
Country	:	US
Telephone Number	:	702-796-1116
Fax Number	:	702-692-4740

Provider Business Practice Location Address
First Line	:	150 E HARMON AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-4533
Country	:	US
Telephone Number	:	702-796-1116
Fax Number	:	702-692-4740

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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Directions to “ WENCESLAO CABALUNA MD” Practice Location

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