Provider Demographics
NPI:1104043660
Name:GO, SUBIL (MD)
Entity Type:Individual
Prefix:
First Name:SUBIL
Middle Name:
Last Name:GO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1525 PLUMAS CT
Mailing Address - Street 2:STE C
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2971
Mailing Address - Country:US
Mailing Address - Phone:530-822-5575
Mailing Address - Fax:530-822-5585
Practice Address - Street 1:1525 PLUMAS CT
Practice Address - Street 2:STE C
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2971
Practice Address - Country:US
Practice Address - Phone:530-822-5575
Practice Address - Fax:530-822-5585
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA102159207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1104043660Medicaid
P00676238OtherMEDICARE RAILROAD #
CA1104043660Medicaid