1326332271 NPI number — RUBICON PROGRAMS INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326332271 NPI number — RUBICON PROGRAMS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUBICON PROGRAMS INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326332271
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 BISSELL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94804-1815
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-235-2025
Provider Business Mailing Address Fax Number:
510-234-6613

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10217 SAN PABLO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EL CERRITO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94530-3111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-559-1593
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FRIEDMAN
Authorized Official First Name:
HALLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
PROGRAM ADMINISTRATOR/PRIVACY OFFIC
Authorized Official Telephone Number:
510-231-3918

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)