Provider Demographics
NPI:1295941383
Name:RUBIO R. PUNZALAN, MD, INC.
Entity type:Organization
Organization Name:RUBIO R. PUNZALAN, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBIO
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:PUNZALAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-201-9893
Mailing Address - Street 1:427 S GRAND OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-5011
Mailing Address - Country:US
Mailing Address - Phone:626-201-9893
Mailing Address - Fax:
Practice Address - Street 1:427 S GRAND OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-5011
Practice Address - Country:US
Practice Address - Phone:626-201-9893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66411207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty