1013095041 NPI number — INJIL ABUBAKAR MD

Table of content: INJIL ABUBAKAR MD (NPI 1013095041)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013095041 NPI number — INJIL ABUBAKAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABUBAKAR
Provider First Name:
INJIL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABU BAKER
Provider Other First Name:
INJIL
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1013095041
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 VILLAGE GRN N STE 321
Provider Second Line Business Mailing Address:
THE PINEHILLS
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02360-8803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-224-2224
Provider Business Mailing Address Fax Number:
508-224-1778

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 LARKSPUR LANDING CIR STE 10
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARKSPUR
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94939-1836
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-924-1214
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  231258 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: C179714 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000042397 . This is a "BMC HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 496383 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2134861 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7076936 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA92185 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J41906 . This is a "BCBSMA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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