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NPI Code Detail

MEDICARE: ISAAC CABALLERO

MEDICARE: ISAAC CABALLERO
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1427246214
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISAAC CABALLERO
Provider Business Mailing Address
First Line : 1100 N D ST
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92410-3524
Country : US
Telephone Number : 909-381-3774
Fax Number : 909-381-6845
Provider Business Practice Location Address
First Line : 1369 E HIGHLAND AVE
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92404-4640
Country : US
Telephone Number : 909-381-3774
Fax Number : 909-381-6845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2007
Last Update Date : 03/06/2026

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