Provider Demographics
NPI:1598524118
Name:RUIZ, HEIDY NYDIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HEIDY
Middle Name:NYDIA
Last Name:RUIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2935
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-1135
Mailing Address - Country:US
Mailing Address - Phone:877-577-4844
Mailing Address - Fax:
Practice Address - Street 1:17777 CENTER COURT DR N STE 175
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-9320
Practice Address - Country:US
Practice Address - Phone:877-577-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist