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NPI Code Detail

MEDICARE: SONNY J RUBIN MD

MEDICARE:   SONNY J 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
1207L00000XAnesthesiology PhysicianA76500CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891714374
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONNY J RUBIN MD
Provider Business Mailing Address
First Line : 455 OLD NEWPORT BLVD STE 101
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4254
Country : US
Telephone Number : 949-933-7012
Fax Number : 949-387-3380
Provider Business Practice Location Address
First Line : 455 OLD NEWPORT BLVD STE 101
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4254
Country : US
Telephone Number : 949-933-7012
Fax Number : 949-387-3380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 04/01/2015

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