Healthcare Provider Details

I. General information

NPI: 1568605269
Provider Name (Legal Business Name): FELIPE RUIZ D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2009
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

724 MEDICAL CENTER DR E STE 102
CLOVIS CA
93611-6811
US

IV. Provider business mailing address

724 MEDICAL CENTER DR E STE 102
CLOVIS CA
93611-6811
US

V. Phone/Fax

Practice location:
  • Phone: 559-298-7533
  • Fax: 559-900-4761
Mailing address:
  • Phone: 559-298-7533
  • Fax: 559-900-4761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: