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General NPI Number Information
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NPI Number | 1447047568
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Entity Type | Individual
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Provider Name | CHRISTIAN M CRUZ RUIZ CHW
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Gender | Male
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 407 E GILBERT ST STE 6
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-5325
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Country | US
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Telephone | 909-889-1136
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Fax | 909-889-2816
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Provider Business Mailing Address
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Address Line | 5571 CRESTLINE PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-2132
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Country | US
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Telephone | 909-714-8376
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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