Provider Demographics
NPI:1336465111
Name:CADACIO, KATHERINE GABON (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:GABON
Last Name:CADACIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7373 WEST LN
Mailing Address - Street 2:KAISER PERMANENTE - STOCKTON
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95210-3377
Mailing Address - Country:US
Mailing Address - Phone:209-476-3484
Mailing Address - Fax:
Practice Address - Street 1:7373 WEST LN
Practice Address - Street 2:KAISER PERMANENTE - STOCKTON
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95210-3377
Practice Address - Country:US
Practice Address - Phone:209-476-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124995207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine