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General NPI Number Information
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NPI Number | 1447957857
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Entity Type | Individual
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Provider Name | ANDRE MARK CAYABYAB DC
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Gender | Male
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 02/25/2023
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Provider Practice Location Address
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Address Line | 18575 GALE AVE STE 265
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City | CITY OF INDUSTRY
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State | CA
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Zip | 91748-1384
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Country | US
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Telephone | 626-623-8684
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Fax | 626-768-2977
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Provider Business Mailing Address
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Address Line | 16523 POPPYGLEN LN
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City | CERRITOS
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State | CA
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Zip | 90703-2091
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Country | US
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Telephone | 818-730-6276
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 36586
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License Number State | CA
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