Healthcare Provider Details

I. General information

NPI: 1336882737
Provider Name (Legal Business Name): LAURA RUBI CUEVAS MD, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 H STREET CV112
CHULA VISTA CA
91910
US

IV. Provider business mailing address

435 H STREET CV112
CHULA VISTA CA
91910
US

V. Phone/Fax

Practice location:
  • Phone: 661-361-0641
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA190639
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: