Individual
ANTONIO BUENROSTRO RUBIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2210 E ILLINOIS AVE, SUITE 401, FRESNO, CA 93701-2125
(559) 320-0531
(559) 320-0539
Mailing address
4910 E CLINTON WAY, SUITE 101, FRESNO, CA 93727-1560
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA16270
CA
363AS0400X
Surgical Physician Assistant
Primary
PA16270
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA16270
—
CA
Enumeration date
11/11/2006
Last updated
12/03/2011
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