Provider Demographics
NPI:1427251594
Name:VASQUEZ RUBIO, GUSTAVO ADOLFO (MD)
Entity type:Individual
Prefix:DR
First Name:GUSTAVO
Middle Name:ADOLFO
Last Name:VASQUEZ RUBIO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1015 CHESTNUT ST
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4316
Mailing Address - Country:US
Mailing Address - Phone:215-955-7785
Mailing Address - Fax:215-955-9362
Practice Address - Street 1:1015 CHESTNUT ST
Practice Address - Street 2:SUITE 1020
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4316
Practice Address - Country:US
Practice Address - Phone:215-955-7785
Practice Address - Fax:215-955-9362
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2019-10-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD-439046207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine