Provider Demographics
NPI:1326265299
Name:RUBIN, HOWARD STANLEY (MP PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:STANLEY
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MP PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5757 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5810
Mailing Address - Country:US
Mailing Address - Phone:323-964-0866
Mailing Address - Fax:323-964-0868
Practice Address - Street 1:5757 WILSHIRE BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-5810
Practice Address - Country:US
Practice Address - Phone:323-964-0866
Practice Address - Fax:323-964-0868
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY4011103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical