Mark Ericson Ruiz

Primary specialty

DriverTaxonomy code 172A00000X

License

E1378718 Issued in CA

Practice address

2689 Presidio Dr
Brentwood, CA 94513-5609

Phone

(925) 698-1207

Fax

(925) 392-8589

NPI assigned

May 19, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• BR Medivan Inc.

  • Non-emergency Medical Transport (VAN)
  • Brentwood, CA
  • NPI 1235820150
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1396436267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2689 PRESIDIO DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135609",
            "telephone_number": "925-698-1207",
            "fax_number": "925-392-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 PRESIDIO DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135609",
            "telephone_number": "925-698-1207",
            "fax_number": "925-392-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "MARK",
        "middle_name": "ERICSON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "E1378718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiara Rubin
• Imani Latisha Jean Rucks
• Bianca Ruelas-Vazquez
• Rui'S Acupuncture & Herbal Clinic
• Julia Ruiz
• Mina Ryad
• Adriana Arreola Sablan, D.O.
• Safeway Inc
• Fahima Safi
• Bassem Said, M.D.

• Driver in Brentwood, CA
• Providers in Brentwood, CA by specialty
• Driver in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.