Individual
STEPHEN MICHAEL KUBASKA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1211 W. LA PALMA AVENUE, SUITE 505, ANAHEIM, CA 92801-2812
(714) 778-1032
(714) 780-0053
Mailing address
1211 W. LA PALMA AVENUE, SUITE 505, ANAHEIM, CA 92801-2812
(714) 778-1032
(714) 780-0053
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
000000G86545
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G865450
—
CA
Enumeration date
10/16/2006
Last updated
08/24/2011
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