Basic Information
| Provider Information | |||||||||
| NPI: | 1568487858 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SKINNER | ||||||||
| FirstName: | RUBY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 E. CHURCH STREET | ||||||||
| Address2: | ATTENTION: MEDICAL STAFF OFFICE | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057393954 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 316 S. STRATFORD AVENUE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053328195 | ||||||||
| FaxNumber: | 8053328196 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 12/13/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | G81701 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | G81701 | CA | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | G81701 | CA | Y | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery |
No ID Information.