Provider Demographics
NPI:1538496658
Name:KABAFUSION, INC.
Entity Type:Organization
Organization Name:KABAFUSION, INC.
Other - Org Name:KABAFUSION, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MASOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:800-435-3020
Mailing Address - Street 1:17777 CENTER COURT DR N
Mailing Address - Street 2:SUITE 550
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-9320
Mailing Address - Country:US
Mailing Address - Phone:800-435-3020
Mailing Address - Fax:562-645-5396
Practice Address - Street 1:159 MEMORIAL DR STE E
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-6202
Practice Address - Country:US
Practice Address - Phone:888-727-2323
Practice Address - Fax:888-966-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-10
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X, 333600000X, 3336C0003X, 3336C0004X, 3336H0001X, 3336S0011X, 3336S0011X, 3336H0001X
NHNR08783336H0001X
VT036.00743473336H0001X
MN2645403336S0011X
CTPCN.00022413336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148383OtherPK
ME1538496658Medicaid
MA110087439AMedicaid
NC1538496658Medicaid
VT6704661Medicaid
VT6704799Medicaid