Active NPI
Samuel Ruiz, D.C.
- Chiropractor
- La Verne, CA
National Provider Identifier
1407027386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 30862
- Practice address
- 1145 Foothill Blvd
La Verne, CA 91750-3328 - Phone
- (909) 596-2711
- Fax
- (909) 596-2253
- NPI assigned
- Mar 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 30862 | CA | Primary |
Addresses
Primary practice location
1145 Foothill Blvd
La Verne, CA 91750-3328
Mailing address
1145 Foothill Blvd
La Verne, CA 91750-3328
Phone (909) 596-2711
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30862 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1407027386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 FOOTHILL BLVD",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917503328",
"telephone_number": "909-596-2711",
"fax_number": "909-596-2253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1145 FOOTHILL BLVD",
"city": "LA VERNE",
"state": "CA",
"postal_code": "917503328",
"telephone_number": "909-596-2711",
"fax_number": "909-596-2253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-18",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "30862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Verne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.