Provider Demographics
NPI:1699771881
Name:RUA, JOSE A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:RUA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:215 S HICKORY ST
Mailing Address - Street 2:STE 126
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4359
Mailing Address - Country:US
Mailing Address - Phone:760-745-7313
Mailing Address - Fax:760-745-6360
Practice Address - Street 1:215 S HICKORY ST
Practice Address - Street 2:STE 126
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3439
Practice Address - Country:US
Practice Address - Phone:760-745-7313
Practice Address - Fax:760-745-6360
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2011-12-19
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Provider Licenses
StateLicense IDTaxonomies
CAG38761208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE02635Medicare UPIN