Healthcare Provider Details

I. General information

NPI: 1225722952
Provider Name (Legal Business Name): JOSMARIE RUIZ VELEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 H ST
CHULA VISTA CA
91910-4328
US

IV. Provider business mailing address

480 H ST
CHULA VISTA CA
91910-4328
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-2713
  • Fax: 619-585-4390
Mailing address:
  • Phone: 858-499-2713
  • Fax: 619-585-4390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA204960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: