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General NPI Number Information
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NPI Number | 1942789706
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Entity Type | Individual
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Provider Name | ELMER CABALLERO
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Gender | Male
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Dates
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Enumeration Date | 08/12/2018
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 691 E WASHINGTON BLVD
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City | PASADENA
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State | CA
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Zip | 91104
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Country | US
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Telephone | 626-701-0497
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Fax |
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Provider Business Mailing Address
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Address Line | 13080 DRONFIELD AVE
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City | SYLMAR
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State | CA
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Zip | 91342-7401
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Country | US
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Telephone | 747-265-7236
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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