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General NPI Number Information
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NPI Number | 1720204233
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Entity Type | Individual
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Provider Name | DAVID RUSSELL REUBEN D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/17/2014
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Provider Practice Location Address
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Address Line | 28504 SAND CANYON RD #71
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-2155
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Country | US
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Telephone | 661-810-5526
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Fax | 661-252-8798
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Provider Business Mailing Address
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Address Line | 28504 SAND CANYON RD #71
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City | CANYON COUNTRY
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State | CA
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Zip | 91387-2155
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Country | US
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Telephone | 661-810-5526
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Fax | 661-252-8798
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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 | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number | DC18156
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License Number State | CA
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