Provider Demographics
NPI:1265417455
Name:SUBBARAO, DILIPKUMAR B (MD)
Entity type:Individual
Prefix:
First Name:DILIPKUMAR
Middle Name:B
Last Name:SUBBARAO
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 1:43839 N 15TH STREET WEST
Mailing Address - Street 2:HIGH DESERT MEDICAL CORP.
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4956
Mailing Address - Country:US
Mailing Address - Phone:661-945-5984
Mailing Address - Fax:661-951-3360
Practice Address - Street 1:43839 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4756
Practice Address - Country:US
Practice Address - Phone:661-945-5984
Practice Address - Fax:661-951-3360
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
3121291OtherMEDICAID WELFARE
J30323OtherBLUE SHIELD HMO BLUE
130323OtherMEDICARE B
J30323OtherBLUE SHIELD INDEMNITY
W1010450OtherCIGNA HEALTH PLAN
0026740002OtherCIGNA PAL ID
597515OtherFIRST HEALTH
J30323OtherBLUE CARE ELECT
042472266OtherHEALTHCARE VALUE MANAGEME
MA3121291Medicaid
4532386OtherAETNA US HEALTHCARE
26893OtherHEALTH START
3548163OtherCIGNA HEALTHSOURCE
784201OtherMVP HEALTH CARE
3548163OtherCIGNA HEALTHSOURCE
W1010450OtherCIGNA HEALTH PLAN
130323OtherMEDICARE B
0026740002OtherCIGNA PAL ID
3548163OtherCIGNA HEALTHSOURCE
MAJ30323Medicare ID - Type Unspecified