Provider Demographics
NPI:1992798730
Name:CABRERA, JOHN F (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:F
Last Name:CABRERA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:222 W EULALIA ST
Mailing Address - Street 2:STE 211
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2849
Mailing Address - Country:US
Mailing Address - Phone:818-505-4567
Mailing Address - Fax:818-502-4569
Practice Address - Street 1:222 W EULALIA ST
Practice Address - Street 2:SUITE 211
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2849
Practice Address - Country:US
Practice Address - Phone:818-502-4567
Practice Address - Fax:818-502-4569
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2012-01-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG81189207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG03089Medicare UPIN