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General NPI Number Information
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NPI Number | 1649394651
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Entity Type | Organization
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Legal Business Name | RUIZ PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5308 DERRY AVE UNIT K
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4530
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Country | US
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Telephone | 831-373-7222
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Fax | 818-594-3348
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Provider Business Mailing Address
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Address Line | 5308 DERRY AVE UNIT K
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City | AGOURA HILLS
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State | CA
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Zip | 91301-4530
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Country | US
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Telephone | 831-373-7222
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Fax | 818-594-3348
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Authorized Official
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Title or Position | OWNER
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Name | TERESA RAMAPRIYA RUIZ
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Credential | P.T.
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Telephone | 831-373-7222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CA6820
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License Number State | CA
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