Provider Demographics
NPI:1497512800
Name:RUBALCAVA, DIANA FABIOLA (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:FABIOLA
Last Name:RUBALCAVA
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:22764 LA MORE RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-1630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11175 CAMPUS ST # 11120
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1700
Practice Address - Country:US
Practice Address - Phone:909-651-5582
Practice Address - Fax:909-558-0440
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-06
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant