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NPI Code Detail

MEDICARE: NEPHTALI RUIZ GOMEZ M.D.

MEDICARE: NEPHTALI RUIZ GOMEZ M.D.
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
1208600000XSurgery PhysicianA95430CA
2208600000XSurgery PhysicianD68870MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700090073
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEPHTALI RUIZ GOMEZ M.D.
Provider Business Mailing Address
First Line : 11175 CAMPUS ST
Second Line :
City : LOMA LINDA
State : CA
Zip : 92350-1700
Country : US
Telephone Number : 909-558-4286
Fax Number :
Provider Business Practice Location Address
First Line : 11234 ANDERSON ST # 1600
Second Line :
City : LOMA LINDA
State : CA
Zip : 92350-1716
Country : US
Telephone Number : 909-558-2262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 01/16/2026

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Directions to “ NEPHTALI RUIZ GOMEZ M.D.” Practice Location

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