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GRETHEL ALBA CABISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-2440
(909) 580-2441
Mailing address
PO BOX 7, COLTON, CA 92324-0007
(909) 783-9111
(909) 783-9112

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A35550
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A355500
BLUE SHIELD
05
00A355500
CA
01
050091367
RAILROAD MEDICARE
Enumeration date
12/13/2005
Last updated
10/10/2014
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