Glucosamigos PC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

GLUCOSAMIGOS PC

Practice address

1254 S Waterman Ave Ste 28
San Bernardino, CA 92408-2857

Phone

(909) 763-2551

Fax

(866) 475-0054

NPI assigned

Aug 7, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Rita Heng Rubin, RDNNPI 1710643390

Title

President

Phone

(909) 214-6301

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Rita Rubin, RDN

  • Registered Dietitian
  • San Bernardino, CA
  • NPI 1710643390

  Dietitian, Registered

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1841972007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1254 S WATERMAN AVE STE 28",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082857",
            "telephone_number": "909-763-2551",
            "fax_number": "866-475-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 S WATERMAN AVE STE 28",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924082857",
            "telephone_number": "909-763-2551",
            "fax_number": "866-475-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLUCOSAMIGOS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "RUBIN",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "HENG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-214-6301",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Horatius Gittens, MFTI
• Gustavia Givens Jr.
• Joni Renee Glackin, LCSW
• Rosemary Glaven
• Evangeline Riley Glazier
• Philip Glukhovsky, D.C.
• GMC Health Services Inc
• GMR Dental Hygiene Group
• Kristi Gober
• George Gobles

• Registered Dietitian in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.