Provider Demographics
NPI:1083646871
Name:JAIME D. CABATINGAN, M.D.,S.C.
Entity Type:Organization
Organization Name:JAIME D. CABATINGAN, M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:CABATINGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-375-2800
Mailing Address - Street 1:N28W5901 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-2557
Mailing Address - Country:US
Mailing Address - Phone:262-375-2800
Mailing Address - Fax:262-375-2848
Practice Address - Street 1:N28W5901 LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-2557
Practice Address - Country:US
Practice Address - Phone:262-375-2800
Practice Address - Fax:262-375-2848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI19401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI46015Medicare ID - Type Unspecified