Provider Demographics
NPI:1992838866
Name:FRANK COBARRUBIA DPMPC
Entity Type:Organization
Organization Name:FRANK COBARRUBIA DPMPC
Other - Org Name:FRANK R COBARRUBIA DPM PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:COBARRUBIA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:541-385-7129
Mailing Address - Street 1:2090 NE WYATT CT
Mailing Address - Street 2:STE 201
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7687
Mailing Address - Country:US
Mailing Address - Phone:541-385-7129
Mailing Address - Fax:541-385-7138
Practice Address - Street 1:2090 NE WYATT CT
Practice Address - Street 2:STE. 201
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7687
Practice Address - Country:US
Practice Address - Phone:541-385-7129
Practice Address - Fax:541-385-7138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP000331213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR5849610001Medicare NSC
ORU51184Medicare UPIN
OR136801Medicare PIN