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NPI Code Detail

MEDICARE: MISS MARIANA RUBALCAVA

MEDICARE: MISS MARIANA RUBALCAVA
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
1225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1689703456
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MARIANA RUBALCAVA
Provider Business Mailing Address
First Line : 3750 HALINOR LN
Second Line :
City : BALDWIN PARK
State : CA
Zip : 91706-5622
Country : US
Telephone Number : 323-876-0550
Fax Number : 323-436-7044
Provider Business Practice Location Address
First Line : 7120 FRANKLIN AVE
Second Line :
City : LOS ANGELES
State : CA
Zip : 90046-3002
Country : US
Telephone Number : 323-876-0550
Fax Number : 323-436-7004
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 05/10/2013

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Directions to “ MISS MARIANA RUBALCAVA ” Practice Location

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