Provider Demographics
NPI:1922179639
Name:RUBINSTEIN, RITA H (MD)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:H
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 W CENTRAL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-3010
Mailing Address - Country:US
Mailing Address - Phone:714-990-9421
Mailing Address - Fax:714-990-1475
Practice Address - Street 1:410 W CENTRAL AVE STE 207
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-3010
Practice Address - Country:US
Practice Address - Phone:714-990-9421
Practice Address - Fax:714-990-1475
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A316470Medicaid
CA00A316470Medicaid
CAA31647Medicare ID - Type Unspecified