Provider Demographics
NPI:1699119032
Name:BUSS, ALLISON RUBIN (MD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RUBIN
Last Name:BUSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:NEYHART
Other - Last Name:RUBIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3118 53RD ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1625
Mailing Address - Country:US
Mailing Address - Phone:916-765-0429
Mailing Address - Fax:
Practice Address - Street 1:1955 COWELL BLVD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-6325
Practice Address - Country:US
Practice Address - Phone:530-757-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-27
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143754208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics