Provider Demographics
NPI:1902079569
Name:TOSCANINI, RUBEN DARIO
Entity type:Individual
Prefix:
First Name:RUBEN
Middle Name:DARIO
Last Name:TOSCANINI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4278 QUENTON DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-1555
Mailing Address - Country:US
Mailing Address - Phone:951-850-9882
Mailing Address - Fax:
Practice Address - Street 1:4278 QUENTON DR
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-1555
Practice Address - Country:US
Practice Address - Phone:951-850-9882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA022969172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver