Provider Demographics
NPI:1912081654
Name:CAVERO, PATRICIA GISELA (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:GISELA
Last Name:CAVERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 SOUTHGATE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015
Mailing Address - Country:US
Mailing Address - Phone:650-991-3200
Mailing Address - Fax:650-991-1153
Practice Address - Street 1:1500 SOUTHGATE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-991-3200
Practice Address - Fax:650-991-1153
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65848207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G658480Medicaid
CA00G658480Medicare ID - Type Unspecified
CA00G658480Medicaid