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General NPI Number Information
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NPI Number | 1093388589
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Entity Type | Organization
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Legal Business Name | J.CABALLERO D.D.S., INC
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Dates
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Enumeration Date | 07/21/2021
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 4220 PHELAN RD
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City | PHELAN
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State | CA
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Zip | 92371-3901
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Country | US
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Telephone | 760-868-2783
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Fax | 760-868-5783
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Provider Business Mailing Address
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Address Line | 4220 PHELAN RD
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City | PHELAN
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State | CA
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Zip | 92371-3901
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Country | US
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Telephone | 760-868-2783
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Fax | 760-868-5783
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Authorized Official
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Title or Position | CEO
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Name | MS. JANE ELIZABETH CABALLERO
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Credential | D.D.S
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Telephone | 310-795-3679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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