MEDICARE: DELIA G CABANSAG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	00C381431	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235224015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELIA G CABANSAG MD

Provider Business Mailing Address
First Line	:	1141 E COLORADO ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1308
Country	:	US
Telephone Number	:	818-956-1141
Fax Number	:	323-256-7942

Provider Business Practice Location Address
First Line	:	1141 E COLORADO ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1308
Country	:	US
Telephone Number	:	818-956-1141
Fax Number	:	818-547-4392

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	09/29/2011

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Directions to “ DELIA G CABANSAG MD” Practice Location

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