Healthcare Provider Details

I. General information

NPI: 1639098759
Provider Name (Legal Business Name): ANTONIO CABRERA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 IMPERIAL HWY STE A
DOWNEY CA
90242-3466
US

IV. Provider business mailing address

7320 EXETER ST APT 13
PARAMOUNT CA
90723-3349
US

V. Phone/Fax

Practice location:
  • Phone: 323-538-9050
  • Fax:
Mailing address:
  • Phone: 424-370-9415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: