Provider Demographics
NPI:1508901216
Name:RICHARD A RUBINSTEIN, JR, MD
Entity Type:Organization
Organization Name:RICHARD A RUBINSTEIN, JR, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUBINSTEIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:503-238-1061
Mailing Address - Street 1:5050 NE HOYT ST STE 138
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2955
Mailing Address - Country:US
Mailing Address - Phone:503-238-1061
Mailing Address - Fax:503-238-0841
Practice Address - Street 1:5050 NE HOYT ST STE 138
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2955
Practice Address - Country:US
Practice Address - Phone:503-238-1061
Practice Address - Fax:503-238-0841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD15207207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR044615Medicaid
F10958Medicare UPIN
OR044615Medicaid