MEDICARE: CHARLES-LOUIS DOREGIOS CUADRO

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	373H00000X	Day Training/Habilitation Specialist
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1922880616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES-LOUIS DOREGIOS CUADRO

Provider Business Mailing Address
First Line	:	1828 E 2ND ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-3903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11303 W WASHINGTON BLVD FL 2
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90066-6003
Country	:	US
Telephone Number	:	310-482-6000
Fax Number	:

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

Provider Enumeration Date	:	10/17/2023
Last Update Date	:	03/02/2026

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Directions to “ CHARLES-LOUIS DOREGIOS CUADRO ” Practice Location

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