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NPI Code Detail

MEDICARE: ISKRA RUIZ

MEDICARE: ISKRA 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
1163W00000XRegistered Nurse95202600CA

Other Identifiers

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

General Provider Information

NPI Number : 1669069423
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISKRA RUIZ
Provider Business Mailing Address
First Line : 2564 NAVARRA DR UNIT 201
Second Line :
City : CARLSBAD
State : CA
Zip : 92009-7071
Country : US
Telephone Number : 760-809-2714
Fax Number :
Provider Business Practice Location Address
First Line : 1380 S 43RD ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-3408
Country : US
Telephone Number : 619-298-3655
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2020
Last Update Date : 12/28/2020

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Directions to “ ISKRA RUIZ ” Practice Location

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