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Organization
EDWARD RUBIN MD
Active
Organization
EDWARD RUBIN MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE FUKUMOTO (MANAGER)
(626) 299-4900
Entity
Organization
Contact information
Practice address
12134 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-3205
(818) 749-7499
(818) 761-2583
Mailing address
12134 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606-3205
(818) 749-7499
(818) 761-2583
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G5507
CA
363A00000X
Physician Assistant
PA11460
CA
363A00000X
Physician Assistant
PA11867
CA
363A00000X
Physician Assistant
PA15767
CA
363A00000X
Physician Assistant
PA16393
CA
363A00000X
Physician Assistant
PA16862
CA
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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