Provider Demographics
NPI:1831374883
Name:BABU, JOOBY (MD)
Entity type:Individual
Prefix:
First Name:JOOBY
Middle Name:
Last Name:BABU
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 1:999 N TUSTIN AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3528
Mailing Address - Country:US
Mailing Address - Phone:714-836-6800
Mailing Address - Fax:714-836-9966
Practice Address - Street 1:999 N TUSTIN AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3528
Practice Address - Country:US
Practice Address - Phone:714-836-6800
Practice Address - Fax:714-836-9966
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA100099207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFB0419641OtherDEA
CABP306UMedicare PIN
CABP306WMedicare PIN
CABP306VMedicare PIN
CABP306XMedicare PIN