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NPI Code Detail

MEDICARE: JOSEPH TEFERI GUBSA

MEDICARE:   JOSEPH TEFERI GUBSA
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1992040729
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH TEFERI GUBSA
Provider Business Mailing Address
First Line : 5154 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-0511
Country : US
Telephone Number : 707-494-3564
Fax Number :
Provider Business Practice Location Address
First Line : 5154 S JONES BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-0511
Country : US
Telephone Number : 707-494-3564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2012
Last Update Date : 12/05/2012

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Directions to “ JOSEPH TEFERI GUBSA ” Practice Location

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