Provider Demographics
NPI:1407972490
Name:AQEEL, RUBINA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUBINA
Middle Name:
Last Name:AQEEL
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 1:12624 VAQUERO CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-9111
Mailing Address - Country:US
Mailing Address - Phone:909-579-6466
Mailing Address - Fax:
Practice Address - Street 1:1183 E FOOTHILL BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4049
Practice Address - Country:US
Practice Address - Phone:909-579-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53565207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A535650Medicaid
CAG67224Medicare UPIN
CA00A535650Medicaid