Organization
CARMEN RUIZ MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARMEN RUIZ M.D. (OWNER)
(918) 605-8140
Entity
Organization
Contact information
Practice address
222 W EULALIA ST STE 100A, GLENDALE, CA 91204-2850
(818) 277-0567
(818) 244-5122
Mailing address
7439 LA PALMA AVE STE 120, BUENA PARK, CA 90620-2655
(714) 522-2001
(714) 522-7503
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003886490
—
CA
01
—
C146537
MEDICAL LICENSE
CA
Enumeration date
11/30/2021
Last updated
11/30/2021
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