MEDICARE: DANIEL RUIZ PLASCENCIA

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	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1982567285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RUIZ PLASCENCIA

Provider Business Mailing Address
First Line	:	2629 CLARENDON AVE FL 2
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4119
Country	:	US
Telephone Number	:	323-584-3700
Fax Number	:	323-978-6963

Provider Business Practice Location Address
First Line	:	2629 CLARENDON AVE FL 2
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-4119
Country	:	US
Telephone Number	:	323-584-3700
Fax Number	:	323-978-6963

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	02/17/2026

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Directions to “ DANIEL RUIZ PLASCENCIA ” Practice Location

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