Healthcare Provider Details

I. General information

NPI: 1568542470
Provider Name (Legal Business Name): RUBEN S THORBUS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 E D ST
LEMOORE CA
93245-9545
US

IV. Provider business mailing address

812 E D ST
LEMOORE CA
93245-9545
US

V. Phone/Fax

Practice location:
  • Phone: 559-925-1000
  • Fax: 559-925-1084
Mailing address:
  • Phone: 559-925-1000
  • Fax: 559-925-1084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG13459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: