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General NPI Number Information
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NPI Number | 1588878391
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Entity Type | Individual
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Provider Name | RUBY SIDDIQUI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9201 W SUNSET BLVD SUITE 718
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-3701
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Country | US
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Telephone | 310-820-0557
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Fax | 310-826-1163
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Provider Business Mailing Address
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Address Line | PO BOX 49658
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City | LOS ANGELES
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State | CA
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Zip | 90049-0658
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Country | US
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Telephone | 310-820-0557
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Fax | 310-826-1163
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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 | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 50414
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License Number State | CA
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