Provider Demographics
NPI:1053758656
Name:SUNE, PABLO ALEJANDRO (MTBC)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:ALEJANDRO
Last Name:SUNE
Suffix:
Gender:M
Credentials:MTBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 DEANE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2315
Mailing Address - Country:US
Mailing Address - Phone:562-335-3049
Mailing Address - Fax:323-298-3012
Practice Address - Street 1:5418 DEANE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2315
Practice Address - Country:US
Practice Address - Phone:562-335-3049
Practice Address - Fax:323-298-3012
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA09343225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist