Individual
MR. MARK ERICSON RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2689 PRESIDIO DR, BRENTWOOD, CA 94513-5609
(925) 698-1207
(925) 392-8589
Mailing address
2689 PRESIDIO DR, BRENTWOOD, CA 94513-5609
(925) 698-1207
(925) 392-8589
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
E1378718
CA
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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