Organization
GABRIEL RUBANENKO INC A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YETA KHALFIN (OFFICE MANAGER)
(323) 965-5088
Entity
Organization
Contact information
Practice address
6200 WILSHIRE BLVD, SUITE 910, LOS ANGELES, CA 90048-5801
(323) 965-5088
(310) 274-1040
Mailing address
6200 WILSHIRE BLVD, SUITE 908, LOS ANGELES, CA 90048-5801
(323) 965-5088
(310) 274-1040
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A39466
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A394660
—
CA
01
—
A39466
STATE LICENSE #
CA
Enumeration date
05/09/2007
Last updated
03/01/2010
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