Provider Demographics
NPI:1922392315
Name:CABANILLA- DEL MUNDO, CATRISHA CHANTELLE (DO)
Entity Type:Individual
Prefix:MISS
First Name:CATRISHA
Middle Name:CHANTELLE
Last Name:CABANILLA- DEL MUNDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 SWENSON ST
Mailing Address - Street 2:NATHAN ADELSON HOSPICE
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6718
Mailing Address - Country:US
Mailing Address - Phone:702-796-3141
Mailing Address - Fax:702-796-3122
Practice Address - Street 1:4131 SWENSON ST
Practice Address - Street 2:NATHAN ADELSON HOSPICE
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6718
Practice Address - Country:US
Practice Address - Phone:702-796-3141
Practice Address - Fax:702-796-3122
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1900207QH0002X
NVSL0806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine