Individual
BACILIO RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
400 N PEPPER AVE, COLTON, CA 92324-1801
(909) 580-1775
Mailing address
1801 ORANGE TREE LN, REDLANDS, CA 92374-4589
(909) 557-1600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA57725
CA
Other
Enumeration date
09/29/2019
Last updated
10/25/2024
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