Individual
G. THOMAS RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18035 BROOKHURST STREET, SUITE 2100, FOUNTAIN VALLEY, CA 92708
(657) 241-9090
Mailing address
17360 BROOKHURST ST, ATTN: CREDENTIALING DEPT., FOUNTAIN VALLEY, CA 92708-3720
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G69184
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G691840
MEDI CAL
CA
Enumeration date
07/22/2005
Last updated
10/14/2016
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