Organization
R RUIZ M D A PROFESSIONAL CORPORATION
Active
Organization
R RUIZ M D A PROFESSIONAL CORPORATION
Active
Other names
Montebello Clinica Medica Familiar, Clinica Medica Familiar y Dental
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN RUIZ MD (CEO/PRESIDENT)
(562) 201-2508
Entity
Organization
Contact information
Practice address
833 W WHITTIER BLVD, MONTEBELLO, CA 90640-4735
(323) 712-4811
(844) 302-8678
Mailing address
833 W WHITTIER BLVD, MONTEBELLO, CA 90640-4735
(323) 712-4811
(844) 302-8678
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
LAB79356F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2160409
CLIA CERTIFICATE OF WAIVER
CA
05
—
LAB79356F
—
CA
Enumeration date
01/14/2008
Last updated
05/25/2023
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