Healthcare Provider Details
I. General information
NPI: 1639435449
Provider Name (Legal Business Name): JOSEPH A CABARET MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/05/2012
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 E DAILY DR SUITE #228
CAMARILLO CA
93010-5806
US
IV. Provider business mailing address
601 E DAILY DR STE 228
CAMARILLO CA
93010-5840
US
V. Phone/Fax
- Phone: 805-914-0637
- Fax: 805-693-4327
- Phone: 805-914-0637
- Fax: 805-693-4327
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LA0401X |
| Taxonomy | Addiction Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | A51410 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOSEPH
A
CABARET
Title or Position: PRESIDENT/ OWNER
Credential: MD
Phone: 310-792-3914