1790810117 NPI number — FRANKLIN G CABEBE M D INC

Table of content: (NPI 1790810117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790810117 NPI number — FRANKLIN G CABEBE M D INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANKLIN G CABEBE M D INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790810117
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
118 W FOOTHILL BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDORA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91741-3364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-914-3871
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 W FOOTHILL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENDORA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91741-3364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
626-914-3871
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CABEBE
Authorized Official First Name:
FRANKLIN
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
626-914-3871

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  A29760 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A29760 . This is a "PRES. MCAL STATE LICENSE#" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 00A297600 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".