Provider Demographics
NPI:1386859874
Name:RUIZ, MICHAEL J (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:RUIZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8690 ELK GROVE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1787
Mailing Address - Country:US
Mailing Address - Phone:916-686-5172
Mailing Address - Fax:916-686-5179
Practice Address - Street 1:8690 ELK GROVE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1787
Practice Address - Country:US
Practice Address - Phone:916-686-5172
Practice Address - Fax:916-686-5179
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor