Kubotsu, Daryl Tadashi

Kubotsu, Daryl Tadashi is an individual health care provider with primary practice located at 7117 Brockton Ave , Riverside CA 92506-2615. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Kubotsu, Daryl Tadashi can be contacted via phone (951) 782-3853.

Contact Information

Primary practice address
7117 Brockton Ave Riverside CA 92506-2615
Phone: (951) 782-3853
Fax: (951) 784-3269
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA12055 California

Profile Details

NPI number 1558344465
LBN Legal business name Kubotsu, Daryl Tadashi
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 23rd, 2005
Last updated May 9th, 2008 - about 18 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 1558344465 NPPES
Other 1730180415 GROUP NPI#
Other ZZZ318872 GROUP NPI#

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