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Daryl Tadashi Kubotsu, PA
Medical Physician Assistant in Riverside, California
NPI 1558344465

Daryl Tadashi Kubotsu is a Medical Physician Assistant based in Riverside, CA and is specialized in Medical. Daryl Tadashi Kubotsu practices in Riverside, CA and has the professional credentials of PA. The NPI Number for Daryl Tadashi Kubotsu is 1558344465 and holds a License No. PA12055 (California).

The current practice location address for Daryl Tadashi Kubotsu is 7117 Brockton Ave, Riverside, CA and can be reached out via phone at 951-782-3853 and via fax at 951-784-3269. You can also correspond with Daryl Tadashi Kubotsu through the mailing address at 3660 ARLINGTON AVE, RIVERSIDE, CA - 92506-3912 (mailing address contact number: 951-782-3853).

Location: 7117 Brockton Ave, Riverside, CA, 92506-3912
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Provider Profile Details
NPI Number
1558344465
Provider Name
Daryl Tadashi Kubotsu
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
7117 Brockton Ave, Riverside, CA, 92506-3912
Phone Number
951-782-3853
Fax Number
951-784-3269
Provider Enumeration Date
11/23/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1730180415 01 GROUP NPI#
ZZZ318872 01 GROUP SITE #
institution
Provider Business Practice Location Address Details
Address
7117 Brockton Ave
City
State
Zip
92506-2615
Phone Number
951-782-3853
Fax Number
951-784-3269
person
Provider Business Mailing Address Details
Address
7117 Brockton Ave
City
State
Zip
92506-2615
Phone Number
951-782-3853
Fax Number
951-784-3269
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA12055 (California)
Definition
Definition to come...
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