Provider Demographics
NPI:1336279405
Name:DAVID M RUBIN,PH.D.,P.C.
Entity Type:Organization
Organization Name:DAVID M RUBIN,PH.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:520-529-8190
Mailing Address - Street 1:PO BOX 13776
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85732-3776
Mailing Address - Country:US
Mailing Address - Phone:520-529-8190
Mailing Address - Fax:520-529-2557
Practice Address - Street 1:5680 N CAMINO REAL
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-4212
Practice Address - Country:US
Practice Address - Phone:520-529-8190
Practice Address - Fax:520-529-2557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1115103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y05485Medicare UPIN
78256Medicare ID - Type Unspecified