Provider Demographics
NPI:1134322803
Name:CABALLES, ERVIN (CNIM)
Entity Type:Individual
Prefix:
First Name:ERVIN
Middle Name:
Last Name:CABALLES
Suffix:
Gender:M
Credentials:CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 QUEBEC ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-1963
Mailing Address - Country:US
Mailing Address - Phone:303-880-1429
Mailing Address - Fax:303-993-8955
Practice Address - Street 1:1651 QUEBEC ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1963
Practice Address - Country:US
Practice Address - Phone:303-880-1429
Practice Address - Fax:303-993-8955
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic