Individual
BRENT KOKUBUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 S RAYMOND AVE, PASADENA, CA 91105-3229
(626) 795-8051
Mailing address
800 S RAYMOND AVE, PASADENA, CA 91105-3229
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
A158278
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
A158278
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
06/27/2024
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