Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A114735 | CA |
NPI | 1023252350 |
---|---|
Provider Name | Dr. Erik Stephen Cabral |
First Address | Santa Rosa, CA 95403-0182 |
Second Address | Santa Rosa, CA 95403-0182 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2009 |
Last Update Date | 03/04/2018 |