Provider Demographics
NPI:1942221049
Name:KUBO, CALVIN J (MD)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:J
Last Name:KUBO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 STOCKDALE HWY
Mailing Address - Street 2:#203
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3620
Mailing Address - Country:US
Mailing Address - Phone:661-664-0252
Mailing Address - Fax:661-664-2717
Practice Address - Street 1:9500 STOCKDALE HWY
Practice Address - Street 2:#203
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3620
Practice Address - Country:US
Practice Address - Phone:661-664-0252
Practice Address - Fax:661-664-2717
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG69480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G694800Medicare ID - Type Unspecified
CAC85015Medicare UPIN