Provider Demographics
NPI:1891895488
Name:CABAHUG, OMAR BARING (MD)
Entity Type:Individual
Prefix:DR
First Name:OMAR
Middle Name:BARING
Last Name:CABAHUG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WIGWAM PKWY
Mailing Address - Street 2:SUITE 112
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7112
Mailing Address - Country:US
Mailing Address - Phone:702-914-6994
Mailing Address - Fax:702-914-5880
Practice Address - Street 1:2500 WIGWAM PKWY STE 112
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7113
Practice Address - Country:US
Practice Address - Phone:702-914-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV97642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018299Medicaid
NVV35984OtherMEDICARE ID-PIN
NVH56709Medicare UPIN