Individual
JACK RUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10941 BLOOMFIELD ST, SUITE A, LOS ALAMITOS, CA 90720-2530
(562) 596-1667
(562) 596-7514
Mailing address
PO BOX 1127, LOS ALAMITOS, CA 90720-1127
(562) 596-1667
(562) 596-7514
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G70182
CA
207RN0300X
Nephrology Physician
Primary
G70182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G701820
—
CA
Enumeration date
06/27/2005
Last updated
11/15/2013
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