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General NPI Number Information
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NPI Number | 1053413351
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Entity Type | Individual
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Provider Name | GEORGE CABALLERO MSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 W BEVERLY BLVD SUITE 209
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City | MONTEBELLO
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State | CA
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Zip | 90640-4312
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Country | US
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Telephone | 323-255-9421
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Fax | 323-344-9084
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Provider Business Mailing Address
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Address Line | P.O. BOX 411141
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City | LOS ANGELES
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State | CA
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Zip | 90041
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Country | US
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Telephone | 323-255-9421
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Fax | 323-344-9084
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS11522
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License Number State | CA
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