Provider Demographics
NPI:1124907365
Name:CAO, ALVIN LEE CABRERA
Entity type:Individual
Prefix:
First Name:ALVIN LEE
Middle Name:CABRERA
Last Name:CAO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35420 REDBERRY PALMS CT
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-2901
Mailing Address - Country:US
Mailing Address - Phone:626-374-4784
Mailing Address - Fax:
Practice Address - Street 1:35420 REDBERRY PALMS CT
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-2901
Practice Address - Country:US
Practice Address - Phone:626-374-4784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029369363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily