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Organization
TYLER J ROUBIDOUX MD PC
Active
Organization
TYLER J ROUBIDOUX MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER J ROUBIDOUX MD (SOLE OWNER)
(208) 305-3536
Entity
Organization
Contact information
Practice address
11645 WILSHIRE BLVD STE 987, LOS ANGELES, CA 90025-6814
(310) 393-9359
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A127481
CA
Other
Enumeration date
02/26/2018
Last updated
04/25/2018
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