Provider Demographics
NPI:1639373798
Name:KABRA, ASHISH N (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:N
Last Name:KABRA
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 1:3907 WARING RD STE 3
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4454
Mailing Address - Country:US
Mailing Address - Phone:760-224-7766
Mailing Address - Fax:760-726-2305
Practice Address - Street 1:3907 WARING RD STE 3
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4454
Practice Address - Country:US
Practice Address - Phone:760-224-7766
Practice Address - Fax:760-460-9655
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122620207R00000X, 207RC0000X
GA070681207UN0901X
CODR.0066815207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003137713Medicaid
GA003137713Medicaid