Provider Demographics
NPI:1922356377
Name:MELTZER, RUTH MARIE OLIVIA (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:RUTH MARIE
Middle Name:OLIVIA
Last Name:MELTZER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:RUTH MARIE
Other - Middle Name:OLIVIA
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3500 BARRANCA PARKWAY, SUITE 220
Mailing Address - Street 2:COURY & BUEHLER PHYSICAL THERAPY - IRVINE, INC.
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8226
Mailing Address - Country:US
Mailing Address - Phone:949-265-2442
Mailing Address - Fax:949-265-2448
Practice Address - Street 1:3500 BARRANCA PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8226
Practice Address - Country:US
Practice Address - Phone:949-265-2442
Practice Address - Fax:949-265-2448
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT39296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT39296OtherCA PT39296
CACB2.02729Medicare PIN
CACB202730Medicare PIN
CAPT39296AMedicare PIN