Kubota, Marshall Ken

Kubota, Marshall Ken is an individual health care provider with primary practice located at 495 Tesconi Cir , Santa Rosa CA 95401-4619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kubota, Marshall Ken can be contacted via phone (707) 419-7904.

Contact Information

Primary practice address
495 Tesconi Cir Santa Rosa CA 95401-4619
Phone: (707) 419-7904
Fax: (707) 545-2313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G43681 California

Profile Details

NPI number 1245297969
LBN Legal business name Kubota, Marshall Ken
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2006
Last updated Feb 6th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245297969 NPPES
California MEDICAID 00G436810

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