Provider Demographics
NPI:1336152057
Name:SCHUBINER, JEFFREY M (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:SCHUBINER
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 1:1838 EL CAMINO REAL STE 100
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3105
Mailing Address - Country:US
Mailing Address - Phone:650-692-1475
Mailing Address - Fax:650-692-1643
Practice Address - Street 1:1838 EL CAMINO REAL STE 100
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3105
Practice Address - Country:US
Practice Address - Phone:650-692-1475
Practice Address - Fax:650-692-1643
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65076207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23265ZMedicare PIN
CAE75096Medicare UPIN
CA00G650760Medicare PIN