Healthcare Provider Details

I. General information

NPI: 1063906063
Provider Name (Legal Business Name): RUBY MAINI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5725 W LAS POSITAS BLVD STE 100
PLEASANTON CA
94588-4007
US

IV. Provider business mailing address

5725 W LAS POSITAS BLVD STE 100
PLEASANTON CA
94588-4007
US

V. Phone/Fax

Practice location:
  • Phone: 925-734-8130
  • Fax:
Mailing address:
  • Phone: 925-734-8130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA194651
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number338294
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberA194651
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125.073267
License Number StateIL
# 5
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA194651
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: