Individual
SAMANTHA MEHTA KUBASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24401 CALLE DE LA LOUISA STE 200, LAGUNA HILLS, CA 92653
(949) 452-7200
(949) 464-0720
Mailing address
PO BOX 51787, LOS ANGELES, CA 90051-6087
(949) 452-7200
(949) 464-0720
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
A79054
CA
2085R0202X
Diagnostic Radiology Physician
Primary
A79054
CA
2085U0001X
Diagnostic Ultrasound Physician
A79054
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A790540
—
CA
Enumeration date
06/17/2006
Last updated
08/24/2018
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