MEDICARE: ROBA KAMAL ABUSHAABAN

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1659069771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBA KAMAL ABUSHAABAN

Provider Business Mailing Address
First Line	:	9015 MURRAY AVE
Second Line	:
City	:	GILROY
State	:	CA
Zip	:	95020-3673
Country	:	US
Telephone Number	:	408-842-7138
Fax Number	:

Provider Business Practice Location Address
First Line	:	755 W VALLEY DR APT 3
Second Line	:
City	:	CAMPBELL
State	:	CA
Zip	:	95008-5038
Country	:	US
Telephone Number	:	408-515-2239
Fax Number	:

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

Provider Enumeration Date	:	04/26/2023
Last Update Date	:	04/26/2023

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Directions to “ ROBA KAMAL ABUSHAABAN ” Practice Location

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