NPIMap

Organization Active NPI

R Ruiz M D a Medical Corp

Doing business as Rialto Clinica Medica Familiar

  • Primary Care Clinic/Center
  • Rialto, CA
National Provider Identifier
1578599809
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
R RUIZ M D A MEDICAL CORP
Doing business as
Rialto Clinica Medica Familiar
Rialto Clinica Medica Familiar Medical Group, Inc.
Practice address
436 S Riverside Ave
Rialto, CA 92376-6523
Phone
(909) 877-8868
Fax
(909) 877-0008
NPI assigned
Jun 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Authorized official

Name
Ruben Ruiz, MDNPI 1912901471
Title
Ceo/President
Phone
(562) 201-2508

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X G52245 CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

436 S Riverside Ave
Rialto, CA 92376-6523

Mailing address

436 S Riverside Ave
Rialto, CA 92376-6523
Phone (909) 877-8868

Other identifiers 1

IdentifierTypeStateIssuer
GR0060100MedicaidCA

Other names 2

  • Rialto Clinica Medica Familiar Doing business as
  • Rialto Clinica Medica Familiar Medical Group, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308000956 CA Part B Supplier - Clinic/Group Practice 4981592391 Receives reassigned benefits from 11 practitioners
Practice locations: Ontario, CA; Rialto, CA

National Provider Directory

National Provider Directory

Locations

436 S Riverside Ave
Rialto, CA 92376
Phone (909) 877-8668

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684972800000",
    "number": "1578599809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923766523",
            "telephone_number": "909-877-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923766523",
            "telephone_number": "909-877-8868",
            "fax_number": "909-877-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R RUIZ M D A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "RUBEN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "562-201-2508",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G52245",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0060100",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rialto Clinica Medica Familiar",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rialto Clinica Medica Familiar Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.