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NPI Code Detail

MEDICARE: MR. BOB KIGAI MUBALLE BA

MEDICARE:  MR. BOB KIGAI MUBALLE  BA
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1598030678
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BOB KIGAI MUBALLE BA
Provider Business Mailing Address
First Line : 6160 MISSION GORGE RD STE 108
Second Line :
City : SAN DIEGO
State : CA
Zip : 92120-3425
Country : US
Telephone Number : 619-692-8715
Fax Number : 619-481-5219
Provider Business Practice Location Address
First Line : 1250 MORENA BLVD FL 2
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3815
Country : US
Telephone Number : 619-692-8715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2012
Last Update Date : 06/24/2026

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Directions to “ MR. BOB KIGAI MUBALLE BA” Practice Location

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