Individual
MACARIO RUIZ VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19881 HWY 88, STE #5, PINE GROVE, CA 95665
(209) 296-6811
(209) 296-6827
Mailing address
PO BOX 1539, PINE GROVE, CA 95665
(209) 296-6811
(209) 296-6827
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A42097
CA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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