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General NPI Number Information
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NPI Number | 1104831569
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Entity Type | Organization
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Legal Business Name | RICK A RUBIN MD INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 2121 WILSHIRE BLVD 201
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City | SANTA MONICA
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State | CA
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Zip | 90403-5720
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Country | US
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Telephone | 310-264-7300
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Fax | 310-828-8626
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Provider Business Mailing Address
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Address Line | 225 S LAKE AVE 535
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City | PASADENA
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State | CA
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Zip | 91101-3005
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Country | US
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Telephone | 626-795-6596
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Fax | 626-795-8247
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICK ALAN RUBIN
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Credential | M.D.
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Telephone | 310-612-6589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | G36791
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License Number State | CA
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