Provider Demographics
NPI:1528169448
Name:RUBIN, SCOTT ALVIN (MD)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ALVIN
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SCOTT
Other - Middle Name:ALVIN
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5440 WEST SAHARA
Mailing Address - Street 2:STE 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-380-8200
Mailing Address - Fax:702-380-3220
Practice Address - Street 1:5440 WEST SAHARA
Practice Address - Street 2:STE 202
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-380-8200
Practice Address - Fax:702-380-3220
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV61602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019122Medicaid
NV002019122Medicaid
NVMD6160Medicare ID - Type UnspecifiedPROVIDER NUMBER