Healthcare Provider Details

I. General information

NPI: 1831131895
Provider Name (Legal Business Name): ALAN PAUL CUBRE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MEDICAL PLAZA DR SUITE 190
ROSEVILLE CA
95661-2865
US

IV. Provider business mailing address

3637 MISSION AVE SUITE 7
CARMICHAEL CA
95608-2946
US

V. Phone/Fax

Practice location:
  • Phone: 916-786-7498
  • Fax: 916-786-2715
Mailing address:
  • Phone: 916-786-7498
  • Fax: 916-786-2715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG36916
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG36916
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: