Healthcare Provider Details

I. General information

NPI: 1194767988
Provider Name (Legal Business Name): WINNIE YUEH-WEN RUO M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 S PARKER ST STE 150
ORANGE CA
92868-4761
US

IV. Provider business mailing address

17192 MURPHY AVENUE, PO BOX 16246
IRVINE CA
92623-0497
US

V. Phone/Fax

Practice location:
  • Phone: 714-744-0900
  • Fax: 714-744-9232
Mailing address:
  • Phone: 714-347-1000
  • Fax: 714-347-1082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number036084276
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG127748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: