Organization
GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION
Active
Parent organization
GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION
Authorized official
GABRIEL V. RUBANENKO M.D. (PRESIDENT)
(323) 965-5088
Entity
Organization
Contact information
Practice address
6200 WILSHIRE BLVD, SUITE 910, LOS ANGELES, CA 90048-5801
(323) 965-5088
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A39466
CA
Other
Enumeration date
11/18/2013
Last updated
11/18/2013
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