Provider Demographics
NPI:1164780169
Name:FILIAN, RUBEN (PA-C)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:FILIAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 CALLE BELLA
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-3011
Mailing Address - Country:US
Mailing Address - Phone:818-632-9694
Mailing Address - Fax:818-245-6399
Practice Address - Street 1:13754 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-2324
Practice Address - Country:US
Practice Address - Phone:818-616-1373
Practice Address - Fax:818-616-1384
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22272363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1962793695Medicare UPIN