MEDICARE: DR. ROBERT ALAN 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A41009	CA

General Provider Information

NPI Number	:	1659910743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT ALAN RUBIN MD

Provider Business Mailing Address
First Line	:	403 PASEO MIRAMAR
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-6288
Country	:	US
Telephone Number	:	310-970-2288
Fax Number	:

Provider Business Practice Location Address
First Line	:	403 PASEO MIRAMAR
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-6288
Country	:	US
Telephone Number	:	310-970-2288
Fax Number	:

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

Provider Enumeration Date	:	01/06/2020
Last Update Date	:	01/06/2020

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