Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristopher Kevin Caballero Baluyot

Individual provider Neonatal/Pediatric Registered Respiratory Therapist · NPI 1215402185

Kristopher Kevin Caballero Baluyot is a Physician Assistant in Glendale, California. Qualified in 2021, 5 years ago. Practices with Shine Mmg Inc, a 25-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
5
Licensed in
CA
In the registry since
2018
Specialties on file
2

Practice location Address checks out

130 N Brand Blvd Ste 208
Glendale, CA 91203-2627
Phone: (818) 945-6003
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X
Neonatal/Pediatric Registered Respiratory Therapist Taxonomy 2279P3900X · Licence 26505 (CA)

Record details

NPI number1215402185
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 8, 2018
Last updated in NPPESFebruary 20, 2024
Certification dateFebruary 20, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Shine Mmg Inc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare