Provider Demographics
NPI:1477656643
Name:RUBENSTEIN, LISA V (MD)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:V
Last Name:RUBENSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:15501 AZZURE CT
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1505
Mailing Address - Country:US
Mailing Address - Phone:310-472-3235
Mailing Address - Fax:310-472-2538
Practice Address - Street 1:16111 PLUMMER ST
Practice Address - Street 2:VA GREATER LOS ANGELES (152)
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-2036
Practice Address - Country:US
Practice Address - Phone:818-895-9449
Practice Address - Fax:818-895-5838
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG035506207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine