Organization
LOS ANGELES PERIPHERAL ARTERIAL DISEASE CENTER MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK E RUBIN MD (PRESIDENT)
(310) 674-9300
Entity
Organization
Contact information
Practice address
323 N PRAIRIE AVE, SUITE 114, INGLEWOOD, CA 90301-4502
(310) 674-9300
(310) 674-9301
Mailing address
323 N PRAIRIE AVE, SUITE 114, INGLEWOOD, CA 90301-4502
(310) 674-9300
(310) 674-9301
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Enumeration date
02/29/2012
Last updated
02/29/2012
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