MEDICARE: EMILY ARLENE RUBIO PA-C

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	390200000X	Student in an Organized Health Care Education/Training Program		AZ
2	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1093446478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ARLENE RUBIO PA-C

Provider Business Mailing Address
First Line	:	6745 N 51ST DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-3425
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6745 N 51ST DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85301-3425
Country	:	US
Telephone Number	:	623-847-5300
Fax Number	:

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

Provider Enumeration Date	:	06/17/2022
Last Update Date	:	03/17/2023

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