Provider Demographics
NPI:1558476903
Name:CABAYAN, VATCHE (MD)
Entity Type:Individual
Prefix:DR
First Name:VATCHE
Middle Name:
Last Name:CABAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 HILLTOP MALL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94806-1949
Mailing Address - Country:US
Mailing Address - Phone:510-724-4586
Mailing Address - Fax:510-724-9247
Practice Address - Street 1:2970 HILLTOP MALL RD STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94806-1949
Practice Address - Country:US
Practice Address - Phone:510-724-4586
Practice Address - Fax:510-724-9247
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54444207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G544440Medicare ID - Type Unspecified
CAD15564Medicare UPIN