MEDICARE: MR. CHRISTIAN CONSTANTINO RUBIO RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95275941	CA

General Provider Information

NPI Number	:	1568393759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTIAN CONSTANTINO RUBIO RN

Provider Business Mailing Address
First Line	:	6971 SAN PASQUAL CIR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-3028
Country	:	US
Telephone Number	:	310-971-5784
Fax Number	:	310-971-5784

Provider Business Practice Location Address
First Line	:	6971 SAN PASQUAL CIR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-3028
Country	:	US
Telephone Number	:	310-971-5784
Fax Number	:	310-971-5784

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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