Basic Information
Provider Information
NPI: 1780064998
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUEBLER
FirstName: CHRISTOPHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 HILLMONT AVE
Address2:  
City: VENTURA
State: CA
PostalCode: 930031651
CountryCode: US
TelephoneNumber: 8057942433
FaxNumber:  
Practice Location
Address1: 300 HILLMONT AVE
Address2:  
City: VENTURA
State: CA
PostalCode: 930031651
CountryCode: US
TelephoneNumber: 8056526000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2015
LastUpdateDate: 01/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XA161794CAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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