Individual
BERNARD MICHAEL KUBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #365,530,420,120, LOS ANGELES, CA 90095
(310) 206-7663
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 206-7663
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
G66501
CA
207RI0200X
Infectious Disease Physician
Primary
G66501
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G665010
—
CA
Enumeration date
07/19/2006
Last updated
06/29/2010
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