Lad E. Rubaum M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

A30746 Issued in CA

Legal business name

LAD E. RUBAUM M.D.

Practice address

14124 Foothill Blvd
Sylmar, CA 91342-8049

Phone

(818) 367-1012

Fax

(818) 364-2909

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Tawny Tran Penuela, BSN, MBA

Title

Administrator, General Manager

Phone

(818) 367-1012

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669598058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14124 FOOTHILL BLVD",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913428049",
            "telephone_number": "818-367-1012",
            "fax_number": "818-364-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14124 FOOTHILL BLVD",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913428049",
            "telephone_number": "818-367-1012",
            "fax_number": "818-364-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAD E. RUBAUM M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENUELA",
        "authorized_official_first_name": "TAWNY",
        "authorized_official_middle_name": "TRAN",
        "authorized_official_title_or_position": "ADMINISTRATOR, GENERAL MANAGER",
        "authorized_official_telephone_number": "818-367-1012",
        "authorized_official_credential": "BSN, MBA"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A30746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A307461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.