Provider Demographics
NPI:1912116989
Name:AUBERT, HOWARD A (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:A
Last Name:AUBERT
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 1:4646 BROCKTON AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-0104
Mailing Address - Country:US
Mailing Address - Phone:951-585-1800
Mailing Address - Fax:951-585-1801
Practice Address - Street 1:4646 BROCKTON AVE STE 202
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-0104
Practice Address - Country:US
Practice Address - Phone:951-585-1800
Practice Address - Fax:951-585-1801
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143438208800000X
TN46214208800000X
CACA143438208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1521062Medicaid
TN103I346928Medicare PIN