Cable Street Family Practice and Medical Group, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

G84802 Issued in CA

Legal business name

CABLE STREET FAMILY PRACTICE AND MEDICAL GROUP, INC.

Practice address

1808 Cable St
San Diego, CA 92107-3103

Phone

(619) 221-4490

Fax

(619) 221-4494

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Noli A Cava, M.D.NPI 1265453435

Title

Medical Director

Phone

(619) 221-4490

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Noli A. Cava, M.D.

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1265453435
  Medicare reassignment Authorized official
• Kathy Shadle James, DNSC, NP

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1396950135
  NPD (past)
• Nancy H. Rein, MSN, FNP

  • Family Nurse Practitioner
  • San Diego, CA
  • NPI 1972641231
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450656000000",
    "number": "1184834012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073103",
            "telephone_number": "619-221-4490",
            "fax_number": "619-221-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 CABLE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921073103",
            "telephone_number": "619-221-4490",
            "fax_number": "619-221-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABLE STREET FAMILY PRACTICE AND MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2015-12-21",
        "status": "A",
        "authorized_official_last_name": "CAVA",
        "authorized_official_first_name": "NOLI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "619-221-4490",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G84802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "W14659",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3836332",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angel Guillermo Cabeiro
• Elaine Cabello
• Yvette Cabey
• Manuel Edgardo Cabezas, HHP
• Cailin Dayne Cabico, MS, ATC
• Diana Cable
• Kimberly R Cable, CRNA
• Sarah Cables
• Fernando Palis Cabling, OTRL
• Clara Cabot, MD

• Primary Care Clinic/Center in San Diego, CA
• Providers in San Diego, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.