Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 10757 | FL |
Y | 208200000X | Surgeon | 9580790-1205 | UT |
Y | 208600000X | Surgeon | 9580790-1205 | UT |
N | 208200000X | Surgeon | ME108537 | FL |
N | 208600000X | Surgeon | ME108537 | FL |
NPI | 1760542054 |
---|---|
Provider Name | Dr. Ivan Rodrigo Zendejas Ruiz |
First Address | Murray, UT 84107-5716 |
Second Address | Murray, UT 84107-5716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2006 |
Last Update Date | 29/06/2016 |