Provider Demographics
NPI:1396072005
Name:GAMEZ, RUBEN (MD)
Entity type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:GAMEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1712 NEWPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3010
Mailing Address - Country:US
Mailing Address - Phone:949-771-8346
Mailing Address - Fax:
Practice Address - Street 1:1712 NEWPORT BLVD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3010
Practice Address - Country:US
Practice Address - Phone:949-771-8346
Practice Address - Fax:949-415-7964
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104336207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology