Carmen Ruiz MD Inc

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

CARMEN RUIZ MD INC

Practice address

222 W Eulalia St Ste 100a
Glendale, CA 91204-2850

Phone

(818) 277-0567

Fax

(818) 244-5122

NPI assigned

Nov 30, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Carmen Ruiz, M.D.NPI 1003886490

Title

Owner

Phone

(918) 605-8140

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carmen Ruiz, MD

  • Colon & Rectal Surgery Physician
  • Glendale, CA
  • NPI 1003886490
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1407514169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7439 LA PALMA AVE STE 120",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906202655",
            "telephone_number": "714-522-2001",
            "fax_number": "714-522-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST STE 100A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042850",
            "telephone_number": "818-277-0567",
            "fax_number": "818-244-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMEN RUIZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-605-8140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C146537",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003886490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Colon & Rectal Surgery Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Colon & Rectal Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.