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General NPI Number Information
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NPI Number | 1023966132
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Entity Type | Individual
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Provider Name | JOSE GUADALUPE CABALLERO TINOCO
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Gender | Male
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 539 E GLENDALE AVE STE 105
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City | PHOENIX
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State | AZ
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Zip | 85020-4900
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Country | US
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Telephone | 602-241-3145
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Fax | 602-241-2146
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Provider Business Mailing Address
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Address Line | 1650 LYNDON FARM CT STE 300
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City | LOUISVILLE
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State | KY
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Zip | 40223-5005
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Country | US
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Telephone | 726-202-3039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | LPT-034716
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License Number State | AZ
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