Basic Information
| Provider Information | |||||||||
| NPI: | 1710202734 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CABRERA | ||||||||
| FirstName: | JUDITH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10418 VALLEY BLVD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | EL MONTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917313600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264538466 | ||||||||
| FaxNumber: | 6265821411 | ||||||||
| Practice Location | |||||||||
| Address1: | 3401 CENTRE LAKE DR STE 512 | ||||||||
| Address2: | |||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917611201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095660445 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2010 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A121640 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.