Healthcare Provider Details

I. General information

NPI: 1164913299
Provider Name (Legal Business Name): CAROLINE CAHILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 09/18/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

III MEF SURGEONS OFFICE UNIT 35605
FPO AP
96382
US

IV. Provider business mailing address

NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 315-622-3066
  • Fax:
Mailing address:
  • Phone: 630-414-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberE18308
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: