Provider Demographics
NPI:1952578262
Name:KABUTEY, NII-KABU (MD)
Entity Type:Individual
Prefix:DR
First Name:NII-KABU
Middle Name:
Last Name:KABUTEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:333 CITY BLVD W
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2903
Mailing Address - Country:US
Mailing Address - Phone:714-456-5453
Mailing Address - Fax:714-456-6070
Practice Address - Street 1:333 CITY BLVD W
Practice Address - Street 2:SUITE 1600
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2903
Practice Address - Country:US
Practice Address - Phone:714-456-5453
Practice Address - Fax:714-456-6070
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1247022086S0129X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology