Provider Demographics
NPI:1285011387
Name:CABRERA, RICHARD FABIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FABIAN
Last Name:CABRERA
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 1:101 E BEVERLY BLVD
Mailing Address - Street 2:STE 301
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4316
Mailing Address - Country:US
Mailing Address - Phone:951-354-3216
Mailing Address - Fax:951-848-9968
Practice Address - Street 1:9939 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3528
Practice Address - Country:US
Practice Address - Phone:951-687-8802
Practice Address - Fax:951-687-2250
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA150290208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics