Healthcare Provider Details

I. General information

NPI: 1386346021
Provider Name (Legal Business Name): NOEMI JUBAER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341 GOLDEN CENTER DR BLDG B
PLACERVILLE CA
95667-6260
US

IV. Provider business mailing address

PO BOX 45680
SAN FRANCISCO CA
94145-0680
US

V. Phone/Fax

Practice location:
  • Phone: 530-621-3600
  • Fax:
Mailing address:
  • Phone: 530-626-2618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA208296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: