Provider Demographics
NPI:1568605269
Name:RUIZ, FELIPE (DPM)
Entity Type:Individual
Prefix:DR
First Name:FELIPE
Middle Name:
Last Name:RUIZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 MEDICAL CENTER DR E STE 102
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6811
Mailing Address - Country:US
Mailing Address - Phone:559-298-7533
Mailing Address - Fax:559-900-4761
Practice Address - Street 1:724 MEDICAL CENTER DR E STE 102
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6811
Practice Address - Country:US
Practice Address - Phone:559-298-7533
Practice Address - Fax:559-900-4761
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4827213ES0103X
NM330213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE4827OtherCALIFORNIA LICENSE