Provider Demographics
NPI:1487657748
Name:CABALONA, MICHELLE M (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:CABALONA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:18700 N 64TH DR
Mailing Address - Street 2:STE 301
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7114
Mailing Address - Country:US
Mailing Address - Phone:623-561-5437
Mailing Address - Fax:623-561-2316
Practice Address - Street 1:18700 N 64TH DR
Practice Address - Street 2:STE 301
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7114
Practice Address - Country:US
Practice Address - Phone:623-561-5437
Practice Address - Fax:623-561-2316
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2011-07-27
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Provider Licenses
StateLicense IDTaxonomies
AZ33404208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ917247Medicaid