Organization
DENNIS M. CABANGCA
Active
Other names
PEGASUS MEDICAL & AESTHETIC CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS CABANGCA (CEO)
(209) 704-1189
Entity
Organization
Contact information
Practice address
808 IOWA AVE, LOS BANOS, CA 93635-3450
(209) 826-5913
Mailing address
808 IOWA AVE, LOS BANOS, CA 93635-3450
(209) 826-5913
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95002406
NURSE PRACTITIONER FURNISHING
CA
Enumeration date
05/31/2019
Last updated
05/31/2019
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