MEDICARE: TANIA RUIZ

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1225975675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA RUIZ

Provider Business Mailing Address
First Line	:	51640 IDA AVE
Second Line	:
City	:	CABAZON
State	:	CA
Zip	:	92230-5102
Country	:	US
Telephone Number	:	909-801-0787
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 N PALM CANYON DR STE A1-A4
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-1868
Country	:	US
Telephone Number	:	760-424-5602
Fax Number	:

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

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ TANIA RUIZ ” Practice Location

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