Provider Demographics
NPI:1992898944
Name:BELLO, RUBY L (OD)
Entity type:Individual
Prefix:MS
First Name:RUBY
Middle Name:L
Last Name:BELLO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 3RD AVE
Mailing Address - Street 2:#24
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3077
Mailing Address - Country:US
Mailing Address - Phone:858-793-0566
Mailing Address - Fax:
Practice Address - Street 1:3815 3RD AVE
Practice Address - Street 2:#24
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-3077
Practice Address - Country:US
Practice Address - Phone:858-793-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12541T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist