Provider Demographics
NPI:1164407334
Name:RUBIN, ALEXANDER J (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:J
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4675 S YOSEMITE ST
Mailing Address - Street 2:#404
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2534
Mailing Address - Country:US
Mailing Address - Phone:303-316-0512
Mailing Address - Fax:303-745-7997
Practice Address - Street 1:4675 S YOSEMITE ST
Practice Address - Street 2:#404
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2534
Practice Address - Country:US
Practice Address - Phone:303-316-0512
Practice Address - Fax:303-745-7997
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-10
Last Update Date:2015-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO18240207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01182401Medicaid
COAR:192508Medicare ID - Type Unspecified
COC96530Medicare UPIN