Provider Demographics
NPI:1336340710
Name:RUIZ, RICHARD ANTHONY (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANTHONY
Last Name:RUIZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27403 YNEZ RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-5603
Mailing Address - Country:US
Mailing Address - Phone:951-506-0400
Mailing Address - Fax:951-541-9466
Practice Address - Street 1:27403 YNEZ RD
Practice Address - Street 2:SUITE 107
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-5603
Practice Address - Country:US
Practice Address - Phone:951-506-0400
Practice Address - Fax:951-541-9466
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2009-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG068770207Y00000X, 207YP0228X, 207YS0012X, 207YX0007X, 207YX0602X, 207YX0901X, 2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8183132Medicaid
CA8183132Medicaid