Provider Demographics
NPI:1275788788
Name:JUDITH F RUBIN, M.D.
Entity Type:Organization
Organization Name:JUDITH F RUBIN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:FABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-436-5000
Mailing Address - Street 1:227 N EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2807
Mailing Address - Country:US
Mailing Address - Phone:760-436-5000
Mailing Address - Fax:760-634-3191
Practice Address - Street 1:227 N EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2807
Practice Address - Country:US
Practice Address - Phone:760-436-5000
Practice Address - Fax:760-634-3191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty