Provider Demographics
NPI:1326061383
Name:RUBINO, MICHELANGELO A (DC)
Entity Type:Individual
Prefix:
First Name:MICHELANGELO
Middle Name:A
Last Name:RUBINO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 222194
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91322-2194
Mailing Address - Country:US
Mailing Address - Phone:661-644-9152
Mailing Address - Fax:661-253-2901
Practice Address - Street 1:27600 BOUQUET CANYON RD STE 106
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3715
Practice Address - Country:US
Practice Address - Phone:661-296-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30104111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor