Healthcare Provider Details

I. General information

NPI: 1083008411
Provider Name (Legal Business Name): IRMA ZARATE RUANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2015
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 W OLYMPIC BLVD # 3A-300
LOS ANGELES CA
90015-1019
US

IV. Provider business mailing address

3939 ATLANTIC AVE STE 103
LONG BEACH CA
90807-3529
US

V. Phone/Fax

Practice location:
  • Phone: 213-249-9388
  • Fax: 213-389-7993
Mailing address:
  • Phone: 626-577-8480
  • Fax: 626-577-8978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: