# ROBERT A. RUELAZ, MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942505490
- **Authorized official:** MR. PAUL BERNARD (PRESIDENT)
- **Authorized official phone:** (818) 932-4656

## Contact information

- **Practice address:** 801 S CHEVY CHASE DR, SUITE 108, GLENDALE, CA 91205-4431
- **Practice address phone:** (818) 246-2456
- **Mailing address:** 801 S CHEVY CHASE DR, SUITE 108, GLENDALE, CA 91205-4431
- **Mailing address phone:** (818) 246-2456

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | A78097 | CA | — |
| 207RC0000X | Cardiovascular Disease Physician | A78097 | CA | — |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | A78097 | CA | Yes |

## Other

- **Enumeration date:** 01/13/2011
- **Last updated:** 09/30/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | A78097 | CA LICENSE \# | CA |