Provider Demographics
NPI:1639520935
Name:RUBIO, SERGIO R (MD)
Entity Type:Individual
Prefix:
First Name:SERGIO
Middle Name:R
Last Name:RUBIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:515 E MICHELTORENA ST STE C
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-4223
Mailing Address - Country:US
Mailing Address - Phone:805-563-3234
Mailing Address - Fax:805-569-8358
Practice Address - Street 1:515 E MICHELTORENA ST STE C
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-4223
Practice Address - Country:US
Practice Address - Phone:805-618-2109
Practice Address - Fax:805-324-6315
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2019-12-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA154284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA154284OtherMEDICAL BOARD OF CALIFORNIA