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General NPI Number Information
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NPI Number | 1003640988
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Entity Type | Individual
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Provider Name | REICHARD ANDRES RUIZ-PEREZ PA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2024
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Last Update Date | 08/31/2024
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Provider Practice Location Address
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Address Line | 910 E PECOS RD
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City | CHANDLER
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State | AZ
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Zip | 85225-2461
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Country | US
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Telephone | 480-360-4000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 395
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City | RINCON
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State | PR
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Zip | 00677-0395
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10590
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License Number State | AZ
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