MEDICARE: RUTH CHAMBI - HERNANDEZ M.D.

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	207Q00000X	Family Medicine Physician	A87453	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144260118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH CHAMBI - HERNANDEZ M.D.

Provider Business Mailing Address
First Line	:	16954 CRAMER CIR
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92504-6278
Country	:	US
Telephone Number	:	951-531-7242
Fax Number	:

Provider Business Practice Location Address
First Line	:	1871 E 4TH ST
Second Line	:
City	:	ONTARIO
State	:	CA
Zip	:	91764-2601
Country	:	US
Telephone Number	:	909-297-3337
Fax Number	:	909-532-8171

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	09/26/2023

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