Provider Demographics
NPI:1437246956
Name:SUBA, ERIC JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JOHN
Last Name:SUBA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2295 VALLEJO ST
Mailing Address - Street 2:SUITE 508
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4765
Mailing Address - Country:US
Mailing Address - Phone:650-742-3162
Mailing Address - Fax:650-742-3055
Practice Address - Street 1:1200 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-3208
Practice Address - Country:US
Practice Address - Phone:650-742-3162
Practice Address - Fax:650-742-3055
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2023-11-29
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Provider Licenses
StateLicense IDTaxonomies
CAG69017207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA?F59231 ? ?Medicare UPIN