Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 41435 | AZ |
NPI | 1255473872 |
---|---|
Provider Name | Dr. Jodi Leah Rubin |
First Address | Scottsdale, AZ 85260-6280 |
Second Address | Scottsdale, AZ 85260-6278 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 25/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
936799 | (05) | AZ |
K16233 | (02) | IL |