Individual
MR. CARLOS JESSE RUBALCAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
4212 NORTH 16TH STREET, PHOENIX INDIAN MEDICAL CENTER, PHOENIX, AZ 85016-5319
(602) 263-1200
(602) 200-5383
Mailing address
PHOENIX INDIAN MEDICAL CTR, P.O. BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
(602) 200-5383
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN147745
AZ
Other
Enumeration date
04/18/2012
Last updated
04/18/2012
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