Provider Information for 1386276517
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CAITLIN WEBER
Sex: Female
NPI: 1386276517
Last Updated: 2023-02-14
Certification Date: 2023-01-20
Certification Date: 2023-01-20
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1386276517 | ||||||||||||||
| Enumeration Date | 2020-02-05 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | PO BOX 905 SIERRA MADRE, CA 91025-0905 United States Phone: 626-714-0016 | Fax: | ||||||||||||||
| Primary Practice Address | 680 E COLORADO BLVD STE 180&2ND PASADENA, CA 91101-6143 United States Phone: 646-453-6777 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 180 N OAKLAND AVE FL 2 3415 S SEPULVEDA BLVD FL 11 | ||||||||||||||
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