MEDICARE: DR. JUDITH F RUBIN MD

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	207Q00000X	Family Medicine Physician	G70448	CA
2	207Q00000X	Family Medicine Physician	G704480	CA
3	207Q00000X	Family Medicine Physician	MD60222866	WA

General Provider Information

NPI Number	:	1518077452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH F RUBIN MD

Provider Business Mailing Address
First Line	:	3978 SORRENTO VALLEY BLVD
Second Line	:	SUITE 310
City	:	SORRENTO VALLEY
State	:	CA
Zip	:	92121
Country	:	US
Telephone Number	:	858-866-6342
Fax Number	:

Provider Business Practice Location Address
First Line	:	3978 SORRENTO VALLEY BLVD
Second Line	:	SUITE 310
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-1436
Country	:	US
Telephone Number	:	858-866-6342
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/23/2015

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