MEDICARE: DARREN RUTH

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	332B00000X	Durable Medical Equipment & Medical Supplies		CA
2	332BC3200X	Customized Equipment (DME)		CA

General Provider Information

NPI Number	:	1366513558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARREN RUTH

Provider Business Mailing Address
First Line	:	3717 E THOUSAND OAKS BLVD
Second Line	:	#212
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3607
Country	:	US
Telephone Number	:	805-267-1858
Fax Number	:	805-435-0432

Provider Business Practice Location Address
First Line	:	3717 E THOUSAND OAKS BLVD
Second Line	:	#212
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-3607
Country	:	US
Telephone Number	:	805-267-1858
Fax Number	:	805-435-0432

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

Provider Enumeration Date	:	11/11/2006
Last Update Date	:	02/18/2009

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Directions to “ DARREN RUTH ” Practice Location

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