Provider Demographics
NPI:1477537710
Name:COBARRUBIA, FRANK ROBERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ROBERT
Last Name:COBARRUBIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:FRANK
Other - Middle Name:ROBERT
Other - Last Name:COBARRUBIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:1510 SW NANCY WAY STE 2
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3256
Mailing Address - Country:US
Mailing Address - Phone:541-385-7129
Mailing Address - Fax:541-385-7138
Practice Address - Street 1:1510 SW NANCY WAY STE 2
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3256
Practice Address - Country:US
Practice Address - Phone:541-385-7129
Practice Address - Fax:541-385-7138
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP000331213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR20-2456582OtherTAX ID
OR228938Medicaid
OR865318006OtherBLUE CROSS
ORU51184Medicare UPIN
OR228938Medicaid
OR20-2456582OtherTAX ID