Provider Demographics
NPI:1710643390
Name:RUBIN, RITA (RDN)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1179 VIA SAN REMO
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92374-3983
Mailing Address - Country:US
Mailing Address - Phone:909-214-6301
Mailing Address - Fax:
Practice Address - Street 1:1254 S WATERMAN AVE STE 28
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2857
Practice Address - Country:US
Practice Address - Phone:909-763-2551
Practice Address - Fax:866-475-7480
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered