Edward Rubin MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G5507 Issued in CA

Legal business name

EDWARD RUBIN MD

Practice address

12134 Victory Blvd
North Hollywood, CA 91606-3205

Phone

(818) 749-7499

Fax

(818) 761-2583

NPI assigned

Oct 5, 2007

Organization subpart

No

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

Authorized official

Name

Eugene Fukumoto

Title

Manager

Phone

(626) 299-4900

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1497943252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12134 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063205",
            "telephone_number": "818-749-7499",
            "fax_number": "818-761-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12134 VICTORY BLVD",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063205",
            "telephone_number": "818-749-7499",
            "fax_number": "818-761-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD RUBIN MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "FUKUMOTO",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "626-299-4900"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G5507",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11460",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16862",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16393",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA11867",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA15767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.