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General NPI Number Information
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NPI Number | 1487657748
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Entity Type | Individual
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Provider Name | MICHELLE M CABALONA MD
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Gender | Female
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 18700 N 64TH DR STE 301
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City | GLENDALE
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State | AZ
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Zip | 85308-7114
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Country | US
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Telephone | 623-561-5437
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Fax | 623-561-2316
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Provider Business Mailing Address
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Address Line | 18700 N 64TH DR STE 301
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City | GLENDALE
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State | AZ
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Zip | 85308-7114
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Country | US
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Telephone | 623-561-5437
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Fax | 623-561-2316
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 33404
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License Number State | AZ
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