Healthcare Provider Details

I. General information

NPI: 1063749224
Provider Name (Legal Business Name): RUZMED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 11/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12598 CENTRAL AVE SUITE 119
CHINO CA
91710-3502
US

IV. Provider business mailing address

2658 GRIFFITH PARK BLVD STE 180
LOS ANGELES CA
90039-2520
US

V. Phone/Fax

Practice location:
  • Phone: 909-992-3244
  • Fax: 909-614-7345
Mailing address:
  • Phone: 909-992-3244
  • Fax: 909-614-7345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA95544
License Number StateCA

VIII. Authorized Official

Name: XUEJIN QIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 909-992-3244