NPIMap

Organization Active NPI

Gabriel Rubanenko, Inc., a Medical Corporation

  • Non-Pharmacy Dispensing Site
  • Los Angeles, CA
National Provider Identifier
1306276993
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
A39466 Issued in CA
Legal business name
GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION
Practice address
6200 Wilshire Blvd
Suite 910
Los Angeles, CA 90048-5801
Phone
(323) 965-5088
NPI assigned
Nov 18, 2013
Organization subpart
Yes
Parent organization
GABRIEL RUBANENKO, INC., A MEDICAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gabriel V. Rubanenko, M.D.NPI 1194704643
Title
President
Phone
(323) 965-5088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X A39466 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd
Suite 910
Los Angeles, CA 90048-5801

Mailing address

2980 N Beverly Glen Cir
Suite 301
Los Angeles, CA 90077-1726

National Provider Directory

National Provider Directory
Tax ID family
Gabriel Rubanenko MD in3 organizations share this tax ID, including this one
Part of
Gabriel Rubanenko MD in

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1306276993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE 910",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-965-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GABRIEL RUBANENKO, INC., A MEDICAL CORPORATION",
        "enumeration_date": "2013-11-18",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "RUBANENKO",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-965-5088",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A39466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.