Provider Demographics
NPI:1174759211
Name:RUHL, MARCIA (RD)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:
Last Name:RUHL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 N CALIFORNIA AVE
Mailing Address - Street 2:SUITE 13
Mailing Address - City:BEAUMONT
Mailing Address - State:CA
Mailing Address - Zip Code:92223-2113
Mailing Address - Country:US
Mailing Address - Phone:951-769-7853
Mailing Address - Fax:951-769-5502
Practice Address - Street 1:514 N CALIFORNIA AVE
Practice Address - Street 2:SUITE 13
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2113
Practice Address - Country:US
Practice Address - Phone:951-769-7853
Practice Address - Fax:951-769-5502
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered