Provider Demographics
NPI:1346255254
Name:ABUBAKER, FIRAS (MD)
Entity Type:Individual
Prefix:
First Name:FIRAS
Middle Name:
Last Name:ABUBAKER
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 1:160 W FOOTHILL PKWY STE 105-167
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-8545
Mailing Address - Country:US
Mailing Address - Phone:973-330-1940
Mailing Address - Fax:949-299-0023
Practice Address - Street 1:160 W FOOTHILL PKWY STE 105-167
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-8545
Practice Address - Country:US
Practice Address - Phone:973-330-1940
Practice Address - Fax:949-299-0023
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429601207R00000X
CAA101953207RC0200X, 207RI0200X
VA0101246430208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1346255254Medicaid
VA1346255254Medicaid
VAP00854969Medicare PIN