Provider Demographics
NPI:1184653974
Name:RUBINSTEIN, JOAN E (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CA
Mailing Address - Zip Code:93625-2439
Mailing Address - Country:US
Mailing Address - Phone:559-834-1614
Mailing Address - Fax:559-834-0015
Practice Address - Street 1:119 S 6TH ST
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:CA
Practice Address - Zip Code:93625-2439
Practice Address - Country:US
Practice Address - Phone:559-834-1614
Practice Address - Fax:559-834-0015
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37285174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA47026Medicare UPIN