Provider Demographics
NPI:1649517590
Name:RUBOLINO-GALLEGO, MARIA L (FNP)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:L
Last Name:RUBOLINO-GALLEGO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11806 BUFFINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-4685
Mailing Address - Country:US
Mailing Address - Phone:661-587-5859
Mailing Address - Fax:
Practice Address - Street 1:2525 EYE ST
Practice Address - Street 2:SUITE 110
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2064
Practice Address - Country:US
Practice Address - Phone:661-637-0137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12605363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty