Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G068770 | CA |
N | 207YP0228X | Pediatric Otolaryngology | G068770 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | G068770 | CA |
N | 2086X0206X | Surgical Oncologist | G068770 | CA |
NPI | 1336340710 |
---|---|
Provider Name | Dr. Richard Anthony Ruiz |
First Address | Temecula, CA 92591-5603 |
Second Address | Temecula, CA 92591-5603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 20/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8183132 | (05) | CA |
F21966 | (02) | CA |