Individual
CLAUDIA R RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1550 NORTH IMPERIAL AVENUE, SUITE 1, EL CENTRO, CA 92243
(760) 353-4710
(760) 353-6015
Mailing address
516 WEST ATEN ROAD, SUITE 2, IMPERIAL, CA 92251
(760) 355-7730
(760) 355-7731
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17421
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0066310
GROUP #
CA
01
—
WPA17421A
MEDICARE PTAN
CA
01
—
ZZZ47484Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
02/21/2007
Last updated
10/10/2007
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