Provider Demographics
NPI:1396158150
Name:BAKR, RUBEN
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:BAKR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7776 ALLOTT AVE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91402-6408
Mailing Address - Country:US
Mailing Address - Phone:747-202-2000
Mailing Address - Fax:818-670-7888
Practice Address - Street 1:7776 ALLOTT AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91402-6408
Practice Address - Country:US
Practice Address - Phone:747-202-2000
Practice Address - Fax:818-670-7888
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle