Provider Demographics
NPI:1083746382
Name:RUBALCABA, ROSEMARIE
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:RUBALCABA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5144 GARDENIA AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-1116
Mailing Address - Country:US
Mailing Address - Phone:562-900-1413
Mailing Address - Fax:
Practice Address - Street 1:5144 GARDENIA AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-1116
Practice Address - Country:US
Practice Address - Phone:562-900-1413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner