MEDICARE: DR. RUTH ELLEN HASKINS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	G064514	CA

General Provider Information

NPI Number	:	1124009147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH ELLEN HASKINS MD

Provider Business Mailing Address
First Line	:	3444 SMOKEY MOUNTAIN CIR
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-7326
Country	:	US
Telephone Number	:	916-941-0779
Fax Number	:	916-608-8749

Provider Business Practice Location Address
First Line	:	1370 PRAIRIE CITY RD
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-9554
Country	:	US
Telephone Number	:	916-985-9366
Fax Number	:	916-608-8749

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	02/24/2014

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