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General NPI Number Information
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NPI Number | 1164990099
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Entity Type | Organization
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Legal Business Name | RUTH MARQUEZ, O.D. OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 11/08/2018
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 2401 N ROSE AVE
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City | OXNARD
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State | CA
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Zip | 93036-0602
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Country | US
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Telephone | 805-981-4963
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Fax | 805-983-8509
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Provider Business Mailing Address
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Address Line | 2043 RIBERA DR
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City | OXNARD
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State | CA
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Zip | 93030-5493
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Country | US
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Telephone | 213-716-0779
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Fax |
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Authorized Official
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Title or Position | CEO/OPTOMETRIST
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Name | RUTH MARQUEZ
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Credential | O.D.
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Telephone | 805-981-4963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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