Active NPI
Edwin Ruiz
- Driver
- Fontana, CA
National Provider Identifier
1285300301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- D1672667
- Practice address
- 14302 Hillcrest Dr
Fontana, CA 92337-0421 - Phone
- (909) 815-9484
- NPI assigned
- Aug 18, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | D1672667 | CA | Primary |
Addresses
Primary practice location
14302 Hillcrest Dr
Fontana, CA 92337-0421
Mailing address
14302 Hillcrest Dr
Fontana, CA 92337-0421
Phone (909) 815-9484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D1672667 | CA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1285300301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14302 HILLCREST DR",
"city": "FONTANA",
"state": "CA",
"postal_code": "923370421",
"telephone_number": "909-815-9484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14302 HILLCREST DR",
"city": "FONTANA",
"state": "CA",
"postal_code": "923370421",
"telephone_number": "909-815-9484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "EDWIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-18",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "CA",
"license": "D1672667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.