Healthcare Provider Details

I. General information

NPI: 1235006172
Provider Name (Legal Business Name): CAS HEALTH MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9375 ARCHIBALD AVE STE 312
RANCHO CUCAMONGA CA
91730-5703
US

IV. Provider business mailing address

9375 ARCHIBALD AVE STE 312
RANCHO CUCAMONGA CA
91730-5703
US

V. Phone/Fax

Practice location:
  • Phone: 909-755-5010
  • Fax: 909-755-5010
Mailing address:
  • Phone: 909-755-5010
  • Fax: 909-755-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WARREN REGH C GABRILLO III
Title or Position: MANAGER
Credential: MD
Phone: 909-982-2088