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NPI Code Detail

MEDICARE: IVAN CUBAS MD INC

MEDICARE: IVAN CUBAS MD INC
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
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1427885854
Entity Type Code : Organization
Provider Name (Legal Business Name) : IVAN CUBAS MD INC
Provider Business Mailing Address
First Line : PO BOX 27015
Second Line :
City : SAN DIEGO
State : CA
Zip : 92198-1015
Country : US
Telephone Number : 619-489-5611
Fax Number : 619-566-4057
Provider Business Practice Location Address
First Line : 629 THIRD AVE STE A
Second Line :
City : CHULA VISTA
State : CA
Zip : 91910-5786
Country : US
Telephone Number : 619-489-5611
Fax Number : 619-566-4057
Authorized Official
Title or Position : OWNER
Name : IVAN PATRICIO CUBAS
Credential : MD
Telephone Number : 313-595-7329
Provider Enumeration Date : 09/18/2024
Last Update Date : 09/30/2024

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