MEDICARE: ROSEMARY DIAZ RUIZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1669081824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY DIAZ RUIZ

Provider Business Mailing Address
First Line	:	2614 W. STRAWBERRY LN
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706
Country	:	US
Telephone Number	:	714-720-0360
Fax Number	:

Provider Business Practice Location Address
First Line	:	2614 W. STRAWBERRY LN
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92706
Country	:	US
Telephone Number	:	714-720-0360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2020
Last Update Date	:	06/22/2021

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Directions to “ ROSEMARY DIAZ RUIZ ” Practice Location

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