Healthcare Provider Details

I. General information

NPI: 1164407334
Provider Name (Legal Business Name): ALEXANDER J. RUBIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2005
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4675 S YOSEMITE ST #404
DENVER CO
80237-2534
US

IV. Provider business mailing address

4675 S YOSEMITE ST #404
DENVER CO
80237-2534
US

V. Phone/Fax

Practice location:
  • Phone: 303-316-0512
  • Fax: 303-745-7997
Mailing address:
  • Phone: 303-316-0512
  • Fax: 303-745-7997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number18240
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: