MEDICARE: JOSE B CABALLE 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	207R00000X	Internal Medicine Physician	MD038310L	PA

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	:	1386747590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE B CABALLE MD

Provider Business Mailing Address
First Line	:	1432 LINCOLN WAY
Second Line	:	SUITE 201
City	:	MCKEESPORT
State	:	PA
Zip	:	15131-1600
Country	:	US
Telephone Number	:	412-678-7711
Fax Number	:

Provider Business Practice Location Address
First Line	:	1432 LINCOLN WAY
Second Line	:	SUITE 201
City	:	MCKEESPORT
State	:	PA
Zip	:	15131-1600
Country	:	US
Telephone Number	:	412-678-7711
Fax Number	:	412-664-7903

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

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	08/15/2011

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