Provider Demographics
NPI:1962026591
Name:ROBLES, FIDENCIO
Entity Type:Individual
Prefix:
First Name:FIDENCIO
Middle Name:
Last Name:ROBLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PARKCENTER DR STE 235
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3588
Mailing Address - Country:US
Mailing Address - Phone:714-948-7970
Mailing Address - Fax:657-208-1374
Practice Address - Street 1:801 PARKCENTER DR STE 235
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3588
Practice Address - Country:US
Practice Address - Phone:714-948-7970
Practice Address - Fax:657-208-1374
Is Sole Proprietor?:No
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist