Provider Demographics
NPI:1316929540
Name:CABALLERO, CESAR EVARISTO (MD)
Entity type:Individual
Prefix:DR
First Name:CESAR
Middle Name:EVARISTO
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1153 FALLING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-3114
Mailing Address - Country:US
Mailing Address - Phone:703-966-0872
Mailing Address - Fax:
Practice Address - Street 1:1613 OAKWOOD ST
Practice Address - Street 2:BEDFORD MEMORIAL HOSPITAL EMERGENCY DEPARTMENT
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-1213
Practice Address - Country:US
Practice Address - Phone:540-586-9500
Practice Address - Fax:540-586-7364
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101045523207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB82609Medicare UPIN