Provider Demographics
NPI:1427885854
Name:IVAN CUBAS MD INC
Entity type:Organization
Organization Name:IVAN CUBAS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:PATRICIO
Authorized Official - Last Name:CUBAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-595-7329
Mailing Address - Street 1:PO BOX 27015
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92198-1015
Mailing Address - Country:US
Mailing Address - Phone:619-489-5611
Mailing Address - Fax:619-566-4057
Practice Address - Street 1:629 THIRD AVE STE A
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-5786
Practice Address - Country:US
Practice Address - Phone:619-489-5611
Practice Address - Fax:619-566-4057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty