Provider Demographics
NPI:1649238890
Name:RUBENSTEIN, DANIEL J (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13943 N 91ST AVE
Mailing Address - Street 2:C-101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3687
Mailing Address - Country:US
Mailing Address - Phone:623-972-3992
Mailing Address - Fax:623-974-9351
Practice Address - Street 1:13943 N 91ST AVE
Practice Address - Street 2:C-101
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-3687
Practice Address - Country:US
Practice Address - Phone:623-972-3992
Practice Address - Fax:623-974-9351
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2013-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ13098207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0980615OtherAETNA
AZ1649238890OtherAHCCCCS
AZ070003050OtherRAILROAD MEDICARE
AZ99S007000005OtherMEDISUN
AZ099194Medicaid
AZ1Z2340OtherHEALTHNET
AZ732136OtherUNITED HEALTHCARE
AZAZ0251140OtherBLUE CROSS BLUE SHIELD
AZ188961600OtherDEPT OF LABOR WORK COMP
AZ1Z2340OtherHEALTHNET
AZ099194Medicaid