Individual
RANDI E RUBENZIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11130 N TATUM BLVD STE 100, PHOENIX, AZ 85028-1630
(602) 494-1817
(602) 494-7103
Mailing address
11130 N TATUM BLVD STE 100, PHOENIX, AZ 85028-1630
(602) 494-1817
(602) 494-7103
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
26180
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070013969
RAILROAD MEDICARE
AZ
01
—
1588612964
AHCCCS
AZ
01
—
188961600
DEPT OF LABOR WORK COMP
AZ
01
—
1995262
UNITED HEALTHCARE
AZ
01
—
1Z5232
HEALTH NET
AZ
05
—
542557
—
AZ
01
—
7096132
AETNA
AZ
01
—
99S007000006
MEDISUN
AZ
01
—
AZ0869290
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
05/05/2006
Last updated
04/13/2022
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