Provider Demographics
NPI:1174515662
Name:CABALLERO, HECTOR ALBERTO (MD)
Entity type:Individual
Prefix:
First Name:HECTOR
Middle Name:ALBERTO
Last Name:CABALLERO
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 1:32144 AGOURA RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4031
Mailing Address - Country:US
Mailing Address - Phone:805-495-0823
Mailing Address - Fax:818-889-7602
Practice Address - Street 1:32144 AGOURA RD
Practice Address - Street 2:SUITE 118
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4031
Practice Address - Country:US
Practice Address - Phone:805-495-0823
Practice Address - Fax:818-889-7602
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25186207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A24318Medicare UPIN