Healthcare Provider Details
I. General information
NPI: 1205307683
Provider Name (Legal Business Name): RYAN RUBIN CHIROPRACTIC INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2018
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
31360 VIA COLINAS STE 104
WESTLAKE VILLAGE CA
91362-6821
US
IV. Provider business mailing address
31360 VIA COLINAS STE 104
WESTLAKE VILLAGE CA
91362-6821
US
V. Phone/Fax
- Phone: 805-492-1500
- Fax:
- Phone: 805-492-1500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RYAN
TIMOTHY
RUBIN
Title or Position: OWNER
Credential: DC
Phone: 805-428-6208