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General NPI Number Information
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NPI Number | 1881734234
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Entity Type | Organization
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Legal Business Name | PETER R. RUBENSTEIN M D A MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 18411 CLARK ST SUITE 307
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City | TARZANA
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State | CA
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Zip | 91356-3506
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Country | US
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Telephone | 818-708-0700
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Fax | 818-609-0918
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Provider Business Mailing Address
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Address Line | 18411 CLARK ST SUITE 307
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City | TARZANA
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State | CA
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Zip | 91356-3506
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Country | US
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Telephone | 818-708-0700
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Fax | 818-609-0918
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Authorized Official
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Title or Position | M.D.
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Name | DR. PETER R RUBENSTEIN
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Credential | M.D., F.A.C.O.G
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Telephone | 818-708-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G19156
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License Number State | CA
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