Provider Demographics
NPI:1710985320
Name:RUBIN, TERRY N (PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:N
Last Name:RUBIN
Suffix:
Gender:M
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6127 PITCAIRN ST
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5652
Mailing Address - Country:US
Mailing Address - Phone:714-420-6606
Mailing Address - Fax:714-899-1996
Practice Address - Street 1:1665 SCENIC AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-1445
Practice Address - Country:US
Practice Address - Phone:714-436-4554
Practice Address - Fax:714-436-4544
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302981835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy