Provider Demographics
NPI:1891870705
Name:RUBIN, LEWIS ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:ISAAC
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 LAS PALMAS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-2109
Mailing Address - Country:US
Mailing Address - Phone:805-682-2525
Mailing Address - Fax:805-682-2526
Practice Address - Street 1:840 LAS PALMAS DR
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-2109
Practice Address - Country:US
Practice Address - Phone:805-682-2525
Practice Address - Fax:805-682-2526
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-05-15
Deactivation Date:2013-01-11
Deactivation Code:
Reactivation Date:2013-04-30
Provider Licenses
StateLicense IDTaxonomies
CAG22068208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4198917Medicaid
A41470Medicare UPIN
CA4198917Medicaid