Provider Demographics
NPI:1063522472
Name:RUBINSTEIN, EDWARD (DPM)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:RUBINSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:EDWARD
Other - Middle Name:
Other - Last Name:RUBINSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2211 POST ST
Mailing Address - Street 2:STE 203
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3467
Mailing Address - Country:US
Mailing Address - Phone:415-474-5434
Mailing Address - Fax:415-474-5559
Practice Address - Street 1:2211 POST ST
Practice Address - Street 2:STE 203
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3467
Practice Address - Country:US
Practice Address - Phone:415-474-5434
Practice Address - Fax:415-474-5559
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3529213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3925622Medicaid
CA0969420001Medicare NSC
CA3925622Medicaid
CAE35290Medicare PIN