Provider Demographics
NPI:1942551809
Name:HELENE M RUIZ-PLA, MD SC
Entity Type:Organization
Organization Name:HELENE M RUIZ-PLA, MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUIZ-PLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-345-5272
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:
Practice Address - Street 1:1835 BROADWAY ST
Practice Address - Street 2:STE 103
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-2040
Practice Address - Country:US
Practice Address - Phone:708-345-5272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HELENE M RUIZ-PLA, MD SC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site