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General NPI Number Information
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NPI Number | 1982756102
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Entity Type | Individual
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Provider Name | AUSTIN M. KOOBA MD
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Gender | Male
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 420 HEFFERNAN AVE STE D
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City | CALEXICO
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State | CA
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Zip | 92231-4718
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Country | US
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Telephone | 760-270-9126
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Fax | 760-890-0005
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Provider Business Mailing Address
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Address Line | 239 HILL ST # 222
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1141
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Country | US
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Telephone | 858-422-8010
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Fax |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A71262
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License Number State | CA
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