Most Relevant Information
Provider Data
| NPI Number: | 1003019068 |
| Provider Name: | RUSSELL SHUBEN |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | IMF53 |
Most Important Dates
| Enumeration Date: | 06/07/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
6801 COLDWATER CANYON AVE
1 B
NORTH HOLLYWOOD
CA
916055162
Practice Location Phone/Fax
| Phone: | 8187631718 |
| Fax: | 8187637231 |
Provider Mailing Location
6801 COLDWATER CANYON AVE
1 B
NORTH HOLLYWOOD
CA
916055162
Provider Mailing Phone/Fax
| Phone: | 8187631718 |
| Fax: | 8187637231 |