Provider Demographics
NPI:1598914681
Name:RUBINSTEIN, LIDIA M (MD)
Entity Type:Individual
Prefix:DR
First Name:LIDIA
Middle Name:M
Last Name:RUBINSTEIN
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 1:601 LORNA LN
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-4216
Mailing Address - Country:US
Mailing Address - Phone:310-472-2706
Mailing Address - Fax:
Practice Address - Street 1:601 LORNA LN
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-4216
Practice Address - Country:US
Practice Address - Phone:310-472-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24656207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24065Medicare UPIN