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General NPI Number Information
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NPI Number | 1629334420
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Entity Type | Organization
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Legal Business Name | E.S.CABAL JR MD INC
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 29099 HEALTH CAMPUS DR BLDG 3 SUITE280
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City | WESTLAKE
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State | OH
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Zip | 44145-5200
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Country | US
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Telephone | 440-835-6205
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Fax |
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Provider Business Mailing Address
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Address Line | 29099 HEALTH CAMPUS DR BLDG 3 SUITE280
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City | WESTLAKE
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State | OH
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Zip | 44145-5200
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Country | US
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Telephone | 440-835-6205
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OB-GYN
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Name | DR. EUSTAQUIO STEVE CABAL JR.
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Credential | M.D.
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Telephone | 440-835-6205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 35-034397
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License Number State | OH
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