Individual provider Active NPI

Dennis Michael Cavallo, M.D.

  • Otolaryngology Physician
  • Auburn, CA
National Provider Identifier
1730522376
Registry record updated Apr 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
AFE23288 Issued in CA
Practice address
2812 Stevens Dr
Auburn, CA 95602-8806
Phone
(530) 878-1804
NPI assigned
Apr 13, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X AFE23288 CA Primary

Addresses

Primary practice location

2812 Stevens Dr
Auburn, CA 95602-8806

Mailing address

2812 Stevens Dr
Auburn, CA 95602-8806
Phone (530) 878-1804

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AFE23288CAMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1365811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365811200000",
    "number": "1730522376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 STEVENS DR",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956028806",
            "telephone_number": "530-878-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 STEVENS DR",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956028806",
            "telephone_number": "530-878-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLO",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-13",
        "last_updated": "2013-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "AFE23288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2013; 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.