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General NPI Number Information
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NPI Number | 1174341572
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Entity Type | Individual
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Provider Name | MATIAS RUBIO
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Gender | Male
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 387 E AVENIDA DE LOS ARBOLES
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-2933
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Country | US
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Telephone | 805-492-1559
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Fax |
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Provider Business Mailing Address
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Address Line | 2159 SAXE CT
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-3148
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Country | US
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Telephone | 805-660-1457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State | CA
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