Individual
ALEX IVAN RUBIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1633 S ALAMEDA ST STE 101, COMPTON, CA 90220-4976
(310) 627-5600
Mailing address
15716 S LORELLA AVE, GARDENA, CA 90248-2529
(310) 627-5600
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
CA
Enumeration date
08/12/2021
Last updated
08/12/2021
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