Provider Demographics
NPI:1043196181
Name:CABALLERO, ABRAHAM (RN)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 NEWHALL DR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1031
Mailing Address - Country:US
Mailing Address - Phone:310-738-9621
Mailing Address - Fax:
Practice Address - Street 1:505 NEWHALL DR
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1031
Practice Address - Country:US
Practice Address - Phone:310-738-9621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95431429163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty