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NPI Code Detail

MEDICARE: RODOLFO RUIZ-VELASCO MD

MEDICARE: RODOLFO RUIZ-VELASCO 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
1208D00000XGeneral Practice PhysicianA30119CA

General Provider Information

NPI Number : 1407944176
Entity Type Code : Individual
Provider Name (Legal Business Name) : RODOLFO RUIZ-VELASCO MD
Provider Business Mailing Address
First Line : 102 MILE OF CARS WAY
Second Line :
City : NATIONAL CITY
State : CA
Zip : 91950-6603
Country : US
Telephone Number : 619-474-9211
Fax Number : 619-474-2000
Provider Business Practice Location Address
First Line : 102 MILE OF CARS WAY
Second Line :
City : NATIONAL CITY
State : CA
Zip : 91950-6603
Country : US
Telephone Number : 619-474-9211
Fax Number : 619-474-2000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2006
Last Update Date : 07/08/2007

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Directions to “ RODOLFO RUIZ-VELASCO MD” Practice Location

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