Active NPI
Keisuke Kubota
- Case Manager/Care Coordinator
- Indio, CA
National Provider Identifier
1568768885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 81840 Avenue 46
Indio, CA 92201-3936 - Phone
- (760) 391-6999
- Fax
- (760) 391-6998
- NPI assigned
- Feb 3, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
81840 Avenue 46
Indio, CA 92201-3936
Mailing address
5435 Koganehara
Matsudo, CHIBA 2700021
JP
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299456000000",
"number": "1568768885",
"addresses": [
{
"country_code": "JP",
"country_name": "Japan",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "5435 KOGANEHARA",
"city": "MATSUDO",
"state": "CHIBA",
"postal_code": "2700021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81840 AVENUE 46",
"city": "INDIO",
"state": "CA",
"postal_code": "922013936",
"telephone_number": "760-391-6999",
"fax_number": "760-391-6998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBOTA",
"first_name": "KEISUKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-03",
"last_updated": "2011-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.