Provider Demographics
NPI:1831387216
Name:AREF KABBARA MDPC
Entity type:Organization
Organization Name:AREF KABBARA MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AREF
Authorized Official - Middle Name:
Authorized Official - Last Name:KABBARA
Authorized Official - Suffix:
Authorized Official - Credentials:MDPC
Authorized Official - Phone:505-327-7738
Mailing Address - Street 1:810 W APACHE ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5501
Mailing Address - Country:US
Mailing Address - Phone:505-327-7738
Mailing Address - Fax:
Practice Address - Street 1:810 W APACHE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5501
Practice Address - Country:US
Practice Address - Phone:505-327-7738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM81238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty