Provider Demographics
NPI:1588862106
Name:JUAN PABLO FALABELLA , INC
Entity type:Organization
Organization Name:JUAN PABLO FALABELLA , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JUAN PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:FALABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-837-1660
Mailing Address - Street 1:1701 TRUMAN ST.
Mailing Address - Street 2:STE. B
Mailing Address - City:SAN FERNANDO
Mailing Address - State:CA
Mailing Address - Zip Code:91340
Mailing Address - Country:US
Mailing Address - Phone:818-837-1660
Mailing Address - Fax:818-837-1662
Practice Address - Street 1:1701 TRUMAN ST
Practice Address - Street 2:STE. B
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3100
Practice Address - Country:US
Practice Address - Phone:818-837-1660
Practice Address - Fax:818-837-1662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49310261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental