Provider Demographics
NPI:1063674265
Name:CABLING, MARVEN GEREL DOMINGO (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVEN GEREL
Middle Name:DOMINGO
Last Name:CABLING
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 1:11234 ANDERSON ST # MC-1516
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-4499
Mailing Address - Fax:
Practice Address - Street 1:11234 ANDERSON ST # MC-1516
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-28
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60405775207RR0500X
CAA113310207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology