Healthcare Provider Details

I. General information

NPI: 1437811031
Provider Name (Legal Business Name): RUBENS XHEMALAJ OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2021
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 ANDERSON RD STE C
DAVIS CA
95616-0773
US

IV. Provider business mailing address

2019 ANDERSON RD STE C
DAVIS CA
95616-0773
US

V. Phone/Fax

Practice location:
  • Phone: 530-756-5050
  • Fax:
Mailing address:
  • Phone: 530-756-5050
  • Fax: 530-204-5995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: