Provider Demographics
NPI:1851350797
Name:ISHO, LUBNA (DO)
Entity Type:Individual
Prefix:
First Name:LUBNA
Middle Name:
Last Name:ISHO
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:250 W BONITA AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-1863
Mailing Address - Country:US
Mailing Address - Phone:909-392-4747
Mailing Address - Fax:909-392-4767
Practice Address - Street 1:750 N DIAMOND BAR BLVD
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1023
Practice Address - Country:US
Practice Address - Phone:626-331-6411
Practice Address - Fax:626-251-1560
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2021-08-31
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Provider Licenses
StateLicense IDTaxonomies
CA20A8305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI48646Medicare UPIN