Provider Demographics
NPI:1093129009
Name:QUBBA, MOHAMMED (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:
Last Name:QUBBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2923 VIA MORO
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-3541
Mailing Address - Country:US
Mailing Address - Phone:708-673-8258
Mailing Address - Fax:
Practice Address - Street 1:2083 COMPTON AVE STE 203
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92881-3416
Practice Address - Country:US
Practice Address - Phone:951-339-9700
Practice Address - Fax:951-963-7391
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147733207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine