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NPI Code Detail

MEDICARE: HUGO RENE CABRAL

MEDICARE:   HUGO RENE CABRAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry54433CA

General Provider Information

NPI Number : 1215098488
Entity Type Code : Individual
Provider Name (Legal Business Name) : HUGO RENE CABRAL
Provider Business Mailing Address
First Line : 1744 QUAIL LAKES DR
Second Line : APT.2
City : STOCKTON
State : CA
Zip : 95207-5447
Country : US
Telephone Number : 209-623-9802
Fax Number :
Provider Business Practice Location Address
First Line : 678 N WILSON WAY
Second Line : SUITE D
City : STOCKTON
State : CA
Zip : 95205-4272
Country : US
Telephone Number : 209-937-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/08/2007

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Directions to “ HUGO RENE CABRAL ” Practice Location

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