Gordon Philip Reuben, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G40123 Issued in CA

Practice address

2220 Lynn Road
#204
Thousand Oaks, CA 91360-8008

Phone

(805) 497-2201

Fax

(805) 497-6602

NPI assigned

Oct 3, 2006

Last updated

Jan 31, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264896000000",
    "number": "1619061892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LYNN ROAD",
            "address_2": "#204",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608008",
            "telephone_number": "805-497-2201",
            "fax_number": "805-497-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 LYNN ROAD",
            "address_2": "#204",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608008",
            "telephone_number": "805-497-2201",
            "fax_number": "805-497-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REUBEN",
        "first_name": "GORDON",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G40123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G401230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, 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 Jan 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.