Provider Demographics
NPI:1578157228
Name:CAUBLE, SAMUEL (DPT)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:CAUBLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2696
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-0696
Mailing Address - Country:US
Mailing Address - Phone:858-312-6444
Mailing Address - Fax:858-312-6446
Practice Address - Street 1:522 JAMACHA RD
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-2448
Practice Address - Country:US
Practice Address - Phone:619-579-1625
Practice Address - Fax:619-579-1611
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT299517225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty