Provider Demographics
NPI:1528076437
Name:RUBEN CORIANO PLLC
Entity type:Organization
Organization Name:RUBEN CORIANO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PLLC
Authorized Official - Phone:928-373-0233
Mailing Address - Street 1:PO BOX 895
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2339
Mailing Address - Country:US
Mailing Address - Phone:928-373-0233
Mailing Address - Fax:
Practice Address - Street 1:682 S 4TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3075
Practice Address - Country:US
Practice Address - Phone:928-373-0233
Practice Address - Fax:928-783-0519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17677207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
278025Medicare ID - Type Unspecified
E23895Medicare UPIN