Physician Compare National (NPI:1235297318)

HEALTHCARE PROVIDER: RUBEN RUIZ JR. MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1235297318
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385826320
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110311000231
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUIZ
	Individual professional last name
Provider First Name	RUBEN
	Individual professional first name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE DAVIS STREET COMMUNITY CENTER INCORPORATED
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6800956079
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	7
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3081 TEAGARDEN ST
	Group Practice or individual's line 1 address
City	SAN LEANDRO
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945775720
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5103474620
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050283
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	STANFORD HEALTH CARE - VALLEYCARE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y