Healthcare Provider Details

I. General information

NPI: 1285789149
Provider Name (Legal Business Name): ERVIN PAUL RUZICS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 03/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W STEWART DR SEB, 2ND FLOOR
ORANGE CA
92868-3849
US

IV. Provider business mailing address

1100 W STEWART DR SEB, 2ND FLOOR
ORANGE CA
92868-3849
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-8033
  • Fax: 714-744-8803
Mailing address:
  • Phone: 714-771-8033
  • Fax: 714-744-8803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License NumberG51676
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: