Healthcare Provider Details

I. General information

NPI: 1801951645
Provider Name (Legal Business Name): JUAN PABLO CAEIRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 CAMFIELD AVE
COMMERCE CA
90040-1574
US

IV. Provider business mailing address

5427 WHITTIER BLVD
LOS ANGELES CA
90022-4101
US

V. Phone/Fax

Practice location:
  • Phone: 323-869-5448
  • Fax: 323-869-5427
Mailing address:
  • Phone: 323-869-5448
  • Fax: 323-869-5427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberC176327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: