Provider Demographics
NPI:1235184417
Name:CABEL, OLAV (DPT)
Entity Type:Individual
Prefix:
First Name:OLAV
Middle Name:
Last Name:CABEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12830 HESPERIA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-5863
Mailing Address - Country:US
Mailing Address - Phone:760-243-0464
Mailing Address - Fax:760-243-5442
Practice Address - Street 1:12830 HESPERIA RD
Practice Address - Street 2:SUITE A
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5863
Practice Address - Country:US
Practice Address - Phone:760-243-0464
Practice Address - Fax:760-243-5442
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT262590Medicare PIN