Provider Demographics
NPI:1003173824
Name:CABALLERO, ANDREA (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 PROVIDENCE DR STE E3-080
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4657
Mailing Address - Country:US
Mailing Address - Phone:907-375-8785
Mailing Address - Fax:907-375-8788
Practice Address - Street 1:3220 PROVIDENCE DR STE E3-080
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4657
Practice Address - Country:US
Practice Address - Phone:907-375-8785
Practice Address - Fax:907-375-8788
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK123472207RI0200X
LAMD.207569207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease