MEDICARE: DAVID RUELAS

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1669079489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID RUELAS

Provider Business Mailing Address
First Line	:	865 PATRIOT DR STE 202
Second Line	:
City	:	MOORPARK
State	:	CA
Zip	:	93021-3405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301 MEDICAL CENTER DR STE 209
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91307-1922
Country	:	US
Telephone Number	:	805-530-3838
Fax Number	:

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

Provider Enumeration Date	:	10/05/2020
Last Update Date	:	10/05/2020

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Directions to “ DAVID RUELAS ” Practice Location

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