Provider Demographics
NPI:1801135074
Name:RUBEN, DANIEL (MD, MPH, MBA)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:RUBEN
Suffix:
Gender:M
Credentials:MD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15233 CAMARILLO ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1917
Mailing Address - Country:US
Mailing Address - Phone:818-644-3727
Mailing Address - Fax:
Practice Address - Street 1:15233 CAMARILLO ST
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1917
Practice Address - Country:US
Practice Address - Phone:818-644-3727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC415772083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine