Provider Demographics
NPI:1154616977
Name:MATELA, RUBY (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:
Last Name:MATELA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 VIA MARQUESA
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-0923
Mailing Address - Country:US
Mailing Address - Phone:626-679-3249
Mailing Address - Fax:805-535-2763
Practice Address - Street 1:245 S MILLS RD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3435
Practice Address - Country:US
Practice Address - Phone:805-535-2753
Practice Address - Fax:805-535-2763
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57790183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist