Individual
GENNADY RUBINSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3959 LAUREL CANYON BLVD, SUITE F, STUDIO CITY, CA 91604-4921
(818) 505-9300
(818) 505-9292
Mailing address
3959 LAUREL CANYON BLVD, SUITE F, STUDIO CITY, CA 91604-4921
(818) 505-9300
(818) 505-9292
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A74924
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A74924
CA
207ND0900X
Dermatopathology Physician
A74924
CA
207NP0225X
Pediatric Dermatology Physician
A74924
CA
207NS0135X
Procedural Dermatology Physician
A74924
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A749240
—
CA
01
—
A74924
LICENSE NUMBER
CA
Enumeration date
06/16/2005
Last updated
03/07/2008
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