Provider Demographics
NPI:1932720216
Name:RUIZ, PARKER J (PT, DPT)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:J
Last Name:RUIZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 DAYBREAK WAY
Mailing Address - Street 2:
Mailing Address - City:BONSALL
Mailing Address - State:CA
Mailing Address - Zip Code:92003-3723
Mailing Address - Country:US
Mailing Address - Phone:951-970-3129
Mailing Address - Fax:
Practice Address - Street 1:5616 DAYBREAK WAY
Practice Address - Street 2:
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003-3723
Practice Address - Country:US
Practice Address - Phone:951-970-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT298225225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist