Provider Demographics
NPI:1043638935
Name:RUBIN, ZINAIDA
Entity type:Individual
Prefix:
First Name:ZINAIDA
Middle Name:
Last Name:RUBIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 BURBANK BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4823
Mailing Address - Country:US
Mailing Address - Phone:818-989-5422
Mailing Address - Fax:818-989-6244
Practice Address - Street 1:14440 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-4823
Practice Address - Country:US
Practice Address - Phone:818-989-5422
Practice Address - Fax:818-989-6244
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH53669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist