Caccavale, Michael H

Caccavale, Michael H is an individual health care provider with primary practice located at 121 Sotoyome St , Santa Rosa CA 95405-4823. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Caccavale, Michael H can be contacted via phone (707) 546-4062.

Contact Information

Primary practice address
121 Sotoyome St Santa Rosa CA 95405-4823
Phone: (707) 546-4062
Fax: (707) 525-4095
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 49942 Minnesota
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X A121222 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A121222 California

Profile Details

NPI number 1518164425
LBN Legal business name Caccavale, Michael H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2007
Last updated May 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518164425 NPPES
Minnesota MEDICAID 572447100

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