Individual
DR. DOUGLAS J. KUBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2409 15TH ST, SACRAMENTO, CA 95818-2238
(916) 443-8034
(916) 442-6010
Mailing address
2409 15TH ST, SACRAMENTO, CA 95818-2238
(916) 443-8034
(916) 442-6010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T10091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
YYY34870Y
—
CA
Enumeration date
01/20/2006
Last updated
07/14/2010
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