Provider Demographics
NPI:1275580367
Name:MUBIN, TARIQ (MD)
Entity Type:Individual
Prefix:DR
First Name:TARIQ
Middle Name:
Last Name:MUBIN
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 1:5030 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0612
Mailing Address - Country:US
Mailing Address - Phone:661-323-2847
Mailing Address - Fax:661-323-2261
Practice Address - Street 1:5030 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0612
Practice Address - Country:US
Practice Address - Phone:661-323-2847
Practice Address - Fax:661-323-2261
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52644207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47071903801Medicaid
NEH45490Medicare UPIN
CAAQ006ZMedicare PIN
NE47071903801Medicaid