Individual
MARK CUBBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14642 NEWPORT AVE STE 105, TUSTIN, CA 92780-6058
(949) 688-0958
Mailing address
14642 NEWPORT AVE STE 105, TUSTIN, CA 92780-6058
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A158506
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2017
Last updated
11/08/2023
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