Provider Demographics
NPI:1467641282
Name:BRIAN CABLE MD, INC
Entity Type:Organization
Organization Name:BRIAN CABLE MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CABLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-462-6525
Mailing Address - Street 1:235 B HOSPITAL DR.
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4561
Mailing Address - Country:US
Mailing Address - Phone:707-462-6525
Mailing Address - Fax:707-462-6572
Practice Address - Street 1:236 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4561
Practice Address - Country:US
Practice Address - Phone:707-462-6525
Practice Address - Fax:707-462-6572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG80508174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1386743284OtherSINGLE NPI