Healthcare Provider Details

I. General information

NPI: 1568626323
Provider Name (Legal Business Name): MARIA PATRICIA RUIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2008
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6055 E WASHINGTON BLVD 900
COMMERCE CA
90040-2449
US

IV. Provider business mailing address

2433 N EASTERN AVE APT. # 409
LOS ANGELES CA
90032-3262
US

V. Phone/Fax

Practice location:
  • Phone: 323-346-0960
  • Fax: 323-346-0966
Mailing address:
  • Phone: 323-255-2271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: