Organization Active NPI

Caballero Kobzoff MD LLC

  • Internal Medicine Physician
  • Anchorage, AK
National Provider Identifier
1154983294
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CABALLERO KOBZOFF MD LLC
Practice address
4120 Laurel St Ste 204
Anchorage, AK 99508-5392
Phone
(907) 561-4362
Fax
(907) 563-4498
NPI assigned
Jun 28, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Andrea Caballero, MDNPI 1003173824
Title
Owner/Provider
Phone
(907) 561-4362

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4120 Laurel St Ste 204
Anchorage, AK 99508-5392

Mailing address

PO Box 493
Soldotna, AK 99669-0493
Phone (907) 561-4362

National Provider Directory

National Provider Directory

Locations

3220 Providence Dr
Ste E3-080
Anchorage, AK 99508
Phone (907) 375-8785

3220 Providence Dr
Ste E3
Anchorage, AK 99508
Phone (907) 770-3750

4120 Laurel St
Ste 204
Anchorage, AK 99508
Phone (907) 561-4362

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1154983294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996690493",
            "telephone_number": "907-561-4362",
            "fax_number": "907-563-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 LAUREL ST STE 204",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085392",
            "telephone_number": "907-561-4362",
            "fax_number": "907-563-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABALLERO KOBZOFF MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "CABALLERO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "907-561-4362",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.