Organization
JACK RUBIN M D A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK RUBIN MD (OWNER)
(562) 299-5239
Entity
Organization
Contact information
Practice address
1045 ATLANTIC AVE, SUITE 915, LONG BEACH, CA 90813-3408
(562) 596-1667
Mailing address
PO BOX 1127, LOS ALAMITOS, CA 90720-1127
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0084691
—
CA
Enumeration date
09/20/2007
Last updated
12/09/2015
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