Provider Demographics
NPI:1568828671
Name:RUIZ, CEFERINA PULGAR (MD)
Entity Type:Individual
Prefix:DR
First Name:CEFERINA
Middle Name:PULGAR
Last Name:RUIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CEFERINA
Other - Middle Name:MARTINEZ
Other - Last Name:PULGAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6809 FREED MANOR LANE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114
Mailing Address - Country:US
Mailing Address - Phone:619-470-3164
Mailing Address - Fax:
Practice Address - Street 1:6809 FREED MANOR LANE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114
Practice Address - Country:US
Practice Address - Phone:619-470-3164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA36548208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice