Provider Demographics
NPI:1902847726
Name:RUBINA AQEEL MD INC
Entity Type:Organization
Organization Name:RUBINA AQEEL MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBINA
Authorized Official - Middle Name:
Authorized Official - Last Name:AQEEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-579-6466
Mailing Address - Street 1:12624 VAQUERO CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739
Mailing Address - Country:US
Mailing Address - Phone:909-579-6466
Mailing Address - Fax:909-579-6476
Practice Address - Street 1:1183 E FOOTHILL BLVD
Practice Address - Street 2:STE 260
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4049
Practice Address - Country:US
Practice Address - Phone:909-579-6466
Practice Address - Fax:909-579-6476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53565207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A535650Medicaid
CAZZZ26789ZMedicare ID - Type Unspecified
CA00A535650Medicaid