Provider Demographics
NPI:1972393593
Name:CABAN, ANGEL LUIS (PA)
Entity type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:LUIS
Last Name:CABAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1717 CALLE SANTA PRAXEDES
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4229
Mailing Address - Country:US
Mailing Address - Phone:787-696-1718
Mailing Address - Fax:
Practice Address - Street 1:435 AVE PONCE DE LEON
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3424
Practice Address - Country:US
Practice Address - Phone:787-641-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-07
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR2356P.A.363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical