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NPI Code Detail

MEDICARE: PATRICIA KUBOTA

MEDICARE: PATRICIA KUBOTA
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
1175T00000XPeer SpecialistMI

General Provider Information

NPI Number : 1942164579
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA KUBOTA
Provider Business Mailing Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number : 800-757-3257
Fax Number :
Provider Business Practice Location Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number : 800-757-3257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “ PATRICIA KUBOTA ” Practice Location

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