MEDICARE: RUBIN LEVER PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	42032	CA

General Provider Information

NPI Number	:	1003214966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBIN LEVER PT, DPT

Provider Business Mailing Address
First Line	:	4028 E BROADWAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-1502
Country	:	US
Telephone Number	:	562-433-4331
Fax Number	:	562-433-4336

Provider Business Practice Location Address
First Line	:	4028 E BROADWAY
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-1502
Country	:	US
Telephone Number	:	562-433-4331
Fax Number	:	562-433-4336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2014
Last Update Date	:	08/10/2016

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