Healthcare Provider Details

I. General information

NPI: 1184653974
Provider Name (Legal Business Name): JOAN E RUBINSTEIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 11/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 S 6TH ST
FOWLER CA
93625-2439
US

IV. Provider business mailing address

119 S 6TH ST
FOWLER CA
93625-2439
US

V. Phone/Fax

Practice location:
  • Phone: 559-834-1614
  • Fax: 559-834-0015
Mailing address:
  • Phone: 559-834-1614
  • Fax: 559-834-0015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG37285
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: