Healthcare Provider Details

I. General information

NPI: 1366512899
Provider Name (Legal Business Name): HECTOR A CABALLERO MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32144 AGOLLRA ROAD SUITE 11B
WESTLAKE VILLAGE CA
91361-4087
US

IV. Provider business mailing address

32144 AGOLLRA ROAD SUITE 11B
WESTLAKE VILLAGE CA
91361-4087
US

V. Phone/Fax

Practice location:
  • Phone: 805-495-0823
  • Fax: 818-889-7602
Mailing address:
  • Phone: 805-495-0823
  • Fax: 818-889-7602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: HECTOR ALBERTO CABALLERO
Title or Position: PRESIDENT
Credential: MD
Phone: 805-495-0823