Individual provider Active NPI

Stephen Cabalatungan

  • Facial Plastic Surgery Physician
  • Glendale, CA
National Provider Identifier
1265999312
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
PA56597 Issued in CA
Practice address
800 S Central Ave Ste 207
Glendale, CA 91204-4388
Phone
(818) 649-1433
NPI assigned
Feb 25, 2019
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X PA56597 CA Primary

Addresses

Primary practice location

800 S Central Ave Ste 207
Glendale, CA 91204-4388

Mailing address

426 E 212TH St
Carson, CA 90745-1522
Phone (310) 308-6019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PA56597CAMDFacial Plastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1265999312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 E 212TH ST",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907451522",
            "telephone_number": "310-308-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 207",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044388",
            "telephone_number": "818-649-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABALATUNGAN",
        "first_name": "STEPHEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-25",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "CA",
            "license": "PA56597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.