Individual provider Active NPI

Ruth Paez, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Monterey Park, CA
National Provider Identifier
1609104470
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20662 Issued in CA
Practice address
941 S Atlantic Blvd
Suite 101
Monterey Park, CA 91754-4722
Phone
(626) 458-8401
Fax
(626) 458-5606
NPI assigned
Dec 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20662 CA Primary

Addresses

Primary practice location

941 S Atlantic Blvd
Suite 101
Monterey Park, CA 91754-4722

Mailing address

941 S Atlantic Blvd
Suite 101
Monterey Park, CA 91754-4722
Phone (626) 458-8401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120717000612 CA Practitioner - Physician Assistant 6103082292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Zacoalco Medical Group IncGroup PAC ID 4183667629, 5 clinicians

Practice addresses (Care Compare)

5901 Niles St
Suite a
Bakersfield, CA 93306-4781
Phone (661) 363-7232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
20662CAMDOccupational Therapist
PA20662CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Zacoalco Medical Group Inc CurrentSince Apr 22, 2018 Accepting new patients
R Srinivasan MD Inc Past Accepting new patients

Locations

5901 Niles St
Ste A
Bakersfield, CA 93306
Phone (661) 363-7232

1414 E Florence Ave
Los Angeles, CA 90001
Phone (213) 588-1383

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1260057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1609104470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "941 S ATLANTIC BLVD",
            "address_2": "SUITE 101",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544722",
            "telephone_number": "626-458-8401",
            "fax_number": "626-458-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "941 S ATLANTIC BLVD",
            "address_2": "SUITE 101",
            "city": "MONTEREY PARK",
            "state": "CA",
            "postal_code": "917544722",
            "telephone_number": "626-458-8401",
            "fax_number": "626-458-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAEZ",
        "first_name": "RUTH",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-06",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey Park, CA

Sources for this page

Verify at the official NPI Registry.