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Organization
EDMUNDO RUIZ DAVILA, M.D.,INC.
Active
Organization
EDMUNDO RUIZ DAVILA, M.D.,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LUCILLE JOANNE MENDOZA (OFFICE MANAGER)
(510) 793-7555
Entity
Organization
Contact information
Practice address
4087 PERALTA BLVD, FREMONT, CA 94536-4849
(510) 793-7555
(510) 797-5372
Mailing address
4087 PERALTA BLVD, FREMONT, CA 94536-4849
(510) 793-7555
(510) 797-5372
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0881663
CLIA #
CA
Enumeration date
05/12/2006
Last updated
02/25/2014
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