Provider Demographics
NPI:1992703151
Name:CABRALES, STEVEN X (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:X
Last Name:CABRALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3002
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-0302
Mailing Address - Country:US
Mailing Address - Phone:360-414-2048
Mailing Address - Fax:360-575-6749
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2310
Practice Address - Country:US
Practice Address - Phone:360-501-3500
Practice Address - Fax:360-501-3555
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00029853208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0217047OtherLABOR & IND.
P00392546OtherRAILROAD MEDICARE
WA8943474OtherCRIME VICTIMS
OR56718Medicaid
WA8147530Medicaid
WAF57779Medicare UPIN
P00392546OtherRAILROAD MEDICARE