Provider Demographics
NPI:1437179918
Name:RUBANENKO, DALYA TAUBE (DC)
Entity Type:Individual
Prefix:DR
First Name:DALYA
Middle Name:TAUBE
Last Name:RUBANENKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 MOREHOUSE DR
Mailing Address - Street 2:STE 1700
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-6703
Mailing Address - Country:US
Mailing Address - Phone:858-220-0701
Mailing Address - Fax:858-455-5014
Practice Address - Street 1:5440 MOREHOUSE DR
Practice Address - Street 2:STE 1700
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-6703
Practice Address - Country:US
Practice Address - Phone:858-455-7654
Practice Address - Fax:858-455-5014
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26485111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU98233Medicare UPIN
CA26485Medicare ID - Type Unspecified