Provider Demographics
NPI:1114735990
Name:RUBALCAVA, RUBEN (DC)
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:RUBALCAVA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 7TH ST # 1
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4004
Mailing Address - Country:US
Mailing Address - Phone:415-931-7920
Mailing Address - Fax:
Practice Address - Street 1:222 7TH ST # 1
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4004
Practice Address - Country:US
Practice Address - Phone:415-931-7920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor