Provider Demographics
NPI:1376795377
Name:RUIZ, MELISSA JULIA (MD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:JULIA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3291 LOMA VISTA ROAD #302
Mailing Address - Street 2:PEDIATRIC DIAGNOSTIC CENTER
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3099
Mailing Address - Country:US
Mailing Address - Phone:805-652-6255
Mailing Address - Fax:
Practice Address - Street 1:3291 LOMA VISTA ROAD #302
Practice Address - Street 2:PEDIATRIC DIAGNOSTIC CENTER
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3099
Practice Address - Country:US
Practice Address - Phone:805-652-6255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-21
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036126302208000000X
CAA 137641208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics