# GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1306276993
- **Legal business name:** GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION
- **Authorized official:** GABRIEL V. RUBANENKO M.D. (PRESIDENT)
- **Authorized official phone:** (323) 965-5088

## Contact information

- **Practice address:** 6200 WILSHIRE BLVD, SUITE 910, LOS ANGELES, CA 90048-5801
- **Practice address phone:** (323) 965-5088
- **Mailing address:** 2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | A39466 | CA | Yes |

## Other

- **Enumeration date:** 11/18/2013
- **Last updated:** 11/18/2013