Provider Demographics
NPI:1467903211
Name:CABUSAS, AURELIO
Entity Type:Individual
Prefix:MR
First Name:AURELIO
Middle Name:
Last Name:CABUSAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8099 N PAULA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4992
Mailing Address - Country:US
Mailing Address - Phone:559-917-4841
Mailing Address - Fax:
Practice Address - Street 1:8099 N PAULA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4992
Practice Address - Country:US
Practice Address - Phone:559-917-4841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA521750163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse