Provider Demographics
NPI:1851061980
Name:RUBIO, ANTONIO JR (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:
Last Name:RUBIO
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12737 GUN AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-3106
Mailing Address - Country:US
Mailing Address - Phone:909-979-0422
Mailing Address - Fax:
Practice Address - Street 1:7921 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1901
Practice Address - Country:US
Practice Address - Phone:714-847-8751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT300694208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation