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General NPI Number Information
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NPI Number | 1164461224
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Entity Type | Individual
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Provider Name | JOHN W. SKUBIC M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 1901 W LUGONIA AVE STE 310
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City | REDLANDS
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State | CA
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Zip | 92374-9706
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Country | US
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Telephone | 909-557-1600
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Fax | 909-557-1732
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Provider Business Mailing Address
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Address Line | 1801 ORANGE TREE LN STE 200
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City | REDLANDS
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State | CA
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Zip | 92374-4587
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Country | US
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Telephone | 909-557-1600
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Fax | 909-796-4158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G54082
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License Number State | CA
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