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NPI Code Detail

MEDICARE: DR. CESAR EVARISTO CABALLERO M.D.

MEDICARE: DR. CESAR EVARISTO CABALLERO M.D.
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
1207Q00000XFamily Medicine Physician0101045523VA

General Provider Information

NPI Number : 1316929540
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CESAR EVARISTO CABALLERO M.D.
Provider Business Mailing Address
First Line : 1153 FALLING CREEK RD
Second Line :
City : BEDFORD
State : VA
Zip : 24523-3114
Country : US
Telephone Number : 703-966-0872
Fax Number :
Provider Business Practice Location Address
First Line : 1613 OAKWOOD ST
Second Line : BEDFORD MEMORIAL HOSPITAL EMERGENCY DEPARTMENT
City : BEDFORD
State : VA
Zip : 24523-1213
Country : US
Telephone Number : 540-586-9500
Fax Number : 540-586-7364
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 07/08/2007

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