Provider Demographics
NPI:1417192477
Name:RUIZ, ANN MARGARET
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:MARGARET
Last Name:RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ANN
Other - Middle Name:MARGARET
Other - Last Name:MARROQUIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 S VERMONT AVE
Mailing Address - Street 2:STE 605
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-1912
Mailing Address - Country:US
Mailing Address - Phone:213-738-2131
Mailing Address - Fax:213-351-2015
Practice Address - Street 1:550 S VERMONT AVE
Practice Address - Street 2:STE 605
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-1912
Practice Address - Country:US
Practice Address - Phone:213-738-2131
Practice Address - Fax:213-351-2015
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1417192477OtherMEDICAL