Basic Information
Provider Information
NPI: 1003002205
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MAGCALAS
FirstName: CHARITY
MiddleName: CABRERA
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CABRERA
OtherFirstName: CHARITY
OtherMiddleName: SOTELO
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 19125 MERION DR
Address2:  
City: PORTER RANCH
State: CA
PostalCode: 913261834
CountryCode: US
TelephoneNumber: 8183665259
FaxNumber:  
Practice Location
Address1: 13652 CANTARA ST
Address2:  
City: PANORAMA CITY
State: CA
PostalCode: 914025423
CountryCode: US
TelephoneNumber: 8183752391
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/20/2007
LastUpdateDate: 01/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X3564CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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