Provider Demographics
NPI:1124355441
Name:CABLE, DANIEL WILLIAM (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WILLIAM
Last Name:CABLE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CARMEN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7729
Mailing Address - Country:US
Mailing Address - Phone:805-332-4568
Mailing Address - Fax:800-417-9245
Practice Address - Street 1:135 CARMEN LN
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-7729
Practice Address - Country:US
Practice Address - Phone:805-332-4568
Practice Address - Fax:800-417-9245
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA22057OtherPHYSICIAN ASSISTANT BOARD
WA8564437Medicaid