MEDICARE: MUBINA AZIZ ISANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0120X	Pediatric Surgery Physician	A137737	CA
2	2086S0120X	Pediatric Surgery Physician	A137737	IL

General Provider Information

NPI Number	:	1346502507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUBINA AZIZ ISANI MD

Provider Business Mailing Address
First Line	:	26520 CACTUS AVE
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92555-3927
Country	:	US
Telephone Number	:	951-486-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	26520 CACTUS AVE
Second Line	:
City	:	MORENO VALLEY
State	:	CA
Zip	:	92555-3927
Country	:	US
Telephone Number	:	951-486-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	01/26/2026

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