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General NPI Number Information
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NPI Number | 1154616977
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Entity Type | Individual
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Provider Name | RUBY MATELA PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 245 S MILLS RD
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City | VENTURA
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State | CA
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Zip | 93003-3435
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Country | US
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Telephone | 805-535-2753
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Fax | 805-535-2763
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Provider Business Mailing Address
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Address Line | 743 VIA MARQUESA
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City | CAMARILLO
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State | CA
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Zip | 93012-0923
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Country | US
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Telephone | 626-679-3249
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Fax | 805-535-2763
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 57790
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License Number State | CA
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