Basic Information
| Provider Information | |||||||||
| NPI: | 1720162647 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARKS | ||||||||
| FirstName: | RUTH | ||||||||
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| NameSuffix: | I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 23501 CINEMA DR | ||||||||
| Address2: | 210 | ||||||||
| City: | VALENCIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913555428 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612884800 | ||||||||
| FaxNumber: | 6612543904 | ||||||||
| Practice Location | |||||||||
| Address1: | 25050 PEACHLAND AVE | ||||||||
| Address2: | 203 | ||||||||
| City: | NEWHALL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913212523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6612222800 | ||||||||
| FaxNumber: | 6612553428 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 05/03/2011 | ||||||||
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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 | 163W00000X | 389684 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.