MEDICARE: MAKSIM KUBARKA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1235092016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAKSIM KUBARKA

Provider Business Mailing Address
First Line	:	4457 CASA GRANDE CIR APT 448
Second Line	:
City	:	CYPRESS
State	:	CA
Zip	:	90630-2578
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4132 KATELLA AVE STE 102
Second Line	:
City	:	LOS ALAMITOS
State	:	CA
Zip	:	90720-3491
Country	:	US
Telephone Number	:	562-446-7089
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ MAKSIM KUBARKA ” Practice Location

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