MEDICARE: MARK L RUBIN D.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	111N00000X	Chiropractor	B00648	NV

General Provider Information

NPI Number	:	1619419397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK L RUBIN D.C.

Provider Business Mailing Address
First Line	:	9030 W SAHARA AVE # 1290
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5744
Country	:	US
Telephone Number	:	702-249-0197
Fax Number	:

Provider Business Practice Location Address
First Line	:	9034 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-5744
Country	:	US
Telephone Number	:	702-256-8686
Fax Number	:

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

Provider Enumeration Date	:	11/10/2016
Last Update Date	:	11/10/2016

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