Provider Demographics
NPI:1497703375
Name:FALES, STEVEN C (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:C
Last Name:FALES
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:12900 PARK PLAZA DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9329
Mailing Address - Country:US
Mailing Address - Phone:562-741-4461
Mailing Address - Fax:562-622-2971
Practice Address - Street 1:3150 N TENAYA WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0443
Practice Address - Country:US
Practice Address - Phone:702-869-9200
Practice Address - Fax:702-216-3821
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2015-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV4288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002828Medicaid
NV002002828Medicaid
31431Medicare ID - Type Unspecified