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General NPI Number Information
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NPI Number | 1225995814
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Entity Type | Organization
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Legal Business Name | CACERES MEDICAL GROUP
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 8585 KNOTT AVE STE 101
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City | BUENA PARK
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State | CA
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Zip | 90620-3896
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Country | US
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Telephone | 714-821-8588
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Fax | 714-821-4482
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Provider Business Mailing Address
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Address Line | 8585 KNOTT AVE STE 101
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City | BUENA PARK
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State | CA
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Zip | 90620-3896
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Country | US
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Telephone | 714-821-8588
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Fax | 714-821-4482
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. SAMANTHA GAIL ANG
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Credential |
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Telephone | 714-821-8588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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