Healthcare Provider Details

I. General information

NPI: 1073549499
Provider Name (Legal Business Name): REID RUBSAMEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 YGNACIO VALLEY RD
WALNUT CREEK CA
94598-3122
US

IV. Provider business mailing address

PO BOX 7793
SAN FRANCISCO CA
94120-7793
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-3000
  • Fax: 925-947-5286
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0100027
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG58123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: