Provider Demographics
NPI:1871014266
Name:CABUTAGE, JEFFREY V
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:V
Last Name:CABUTAGE
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:PO BOX 10798
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93912-7798
Mailing Address - Country:US
Mailing Address - Phone:831-585-7037
Mailing Address - Fax:
Practice Address - Street 1:1629 AVENUE D STE C1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3042
Practice Address - Country:US
Practice Address - Phone:831-585-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist