Individual provider Active NPI

Josue Alejandro Villa Ruiz, SA-C

  • Surgical Assistant
  • Signal Hill, CA
National Provider Identifier
1972128312
Registry record updated Jun 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
20-183 Issued in WI
Practice address
2600 Skyline Dr
Signal Hill, CA 90755-3823
Phone
(562) 650-9601
NPI assigned
Jun 11, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 20-183 WI Primary

Addresses

Primary practice location

2600 Skyline Dr
Signal Hill, CA 90755-3823

Mailing address

2600 Skyline Dr
Signal Hill, CA 90755-3823
Phone (562) 650-9601

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20-183WIMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1972128312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SKYLINE DR",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907553823",
            "telephone_number": "562-650-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SKYLINE DR",
            "city": "SIGNAL HILL",
            "state": "CA",
            "postal_code": "907553823",
            "telephone_number": "562-650-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLA RUIZ",
        "first_name": "JOSUE",
        "middle_name": "ALEJANDRO",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "20-183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Signal Hill, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.