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NPI Code Detail

MEDICARE: DR. HECTOR ALEJANDRO DIEZ CABALLERO MD

MEDICARE: DR. HECTOR ALEJANDRO DIEZ CABALLERO 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
12084P0800XPsychiatry Physician01070378AIN
2390200000XStudent in an Organized Health Care Education/Training Program
32084P0800XPsychiatry Physician82287GA

Other Identifiers

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

General Provider Information

NPI Number : 1639321250
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HECTOR ALEJANDRO DIEZ CABALLERO MD
Provider Business Mailing Address
First Line : 2801 BUFORD HWY NE STE 100
Second Line :
City : BROOKHAVEN
State : GA
Zip : 30329-2146
Country : US
Telephone Number : 678-820-7830
Fax Number : 678-373-0339
Provider Business Practice Location Address
First Line : 2801 BUFORD HWY NE STE 100
Second Line :
City : BROOKHAVEN
State : GA
Zip : 30329-2146
Country : US
Telephone Number : 678-820-7830
Fax Number : 678-373-0339
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2008
Last Update Date : 08/05/2019

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