Individual
JACK E RUBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
575 E HARDY ST, SUITE 322, INGLEWOOD, CA 90301-4036
(310) 671-0488
(310) 671-7618
Mailing address
PO BOX 260458, ENCINO, CA 91426-0458
(818) 784-4201
(818) 784-4206
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G060194
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G60194
—
CA
Enumeration date
09/26/2005
Last updated
05/03/2008
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