Healthcare Provider Details

I. General information

NPI: 1437610979
Provider Name (Legal Business Name): CRISTIAN RUIZ-RUIZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E ANAHEIM ST STE 100
LONG BEACH CA
90813-4051
US

IV. Provider business mailing address

11360 LAUREEN CT
FONTANA CA
92337-9019
US

V. Phone/Fax

Practice location:
  • Phone: 844-822-4646
  • Fax: 562-216-6198
Mailing address:
  • Phone: 909-549-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA194199
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: