Provider Demographics
NPI:1003809286
Name:CABILING, LOUIS C (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:C
Last Name:CABILING
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 1:635 DITTMER AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-1211
Mailing Address - Country:US
Mailing Address - Phone:719-671-0979
Mailing Address - Fax:719-583-5525
Practice Address - Street 1:635 DITTMER AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-1211
Practice Address - Country:US
Practice Address - Phone:719-671-0979
Practice Address - Fax:719-583-5525
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
CO22348208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01223486Medicaid
COD24083Medicare UPIN
CO492948Medicare ID - Type Unspecified