Provider Demographics
NPI:1316026099
Name:CABRERA, MILAGROS CABOTAGE (MD)
Entity Type:Individual
Prefix:
First Name:MILAGROS
Middle Name:CABOTAGE
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 SULLIVAN AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2221
Mailing Address - Country:US
Mailing Address - Phone:650-756-4663
Mailing Address - Fax:650-756-2021
Practice Address - Street 1:1850 SULLIVAN AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2221
Practice Address - Country:US
Practice Address - Phone:650-756-4663
Practice Address - Fax:650-756-2021
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG078372207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0041950Medicaid
CAGR0041950Medicaid
CAG47350Medicare UPIN