Provider Demographics
NPI:1245833102
Name:CABAHUG, VETLANA ANG
Entity type:Individual
Prefix:
First Name:VETLANA
Middle Name:ANG
Last Name:CABAHUG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8263 BUFFALO RANCH AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-4838
Mailing Address - Country:US
Mailing Address - Phone:702-588-9392
Mailing Address - Fax:
Practice Address - Street 1:8080 W TROPICAL PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89149-4529
Practice Address - Country:US
Practice Address - Phone:702-515-7214
Practice Address - Fax:702-515-7217
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18171183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist