| Peter J. Ruane, M.D. Inc. | |
|
5901 W Olympic Blvd Suite #401 Los Angeles CA 90036-4667 | |
| (323) 954-1072 | |
| (323) 954-1081 |
| Full Name | Peter J. Ruane, M.D. Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 5901 W Olympic Blvd, Los Angeles, California |
| Authorized Official Name and Position | Peter Jerome Ruane (PRESIDENT) |
| Authorized Official Contact | 3239541072 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter J. Ruane, M.D. Inc. 5901 W Olympic Blvd Suite #401 Los Angeles CA 90036-4667 Ph: (323) 954-1072 | Peter J. Ruane, M.D. Inc. 5901 W Olympic Blvd Suite #401 Los Angeles CA 90036-4667 Ph: (323) 954-1072 |
| NPI Number | 1881758688 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 10/04/2007 |
| Medicare PECOS PAC ID | 3274586706 |
|---|---|
| Medicare Enrollment ID | O20050224000761 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881758688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | A042947 (California) | Primary |
| Provider Name | Peter J Ruane |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1467640953 PECOS PAC ID: 4981657418 Enrollment ID: I20050225000181 |
| Provider Name | Kenny Davis B Trinidad |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417088469 PECOS PAC ID: 6204850993 Enrollment ID: I20060120000507 |
| Provider Name | Jacob Daniel Collins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033690961 PECOS PAC ID: 6507244902 Enrollment ID: I20220525001556 |
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