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EDMUNDO RUIZ DAVILA, M.D.,INC.
NPI 1245281682
Family Medicine in Fremont, CA

Active since May 12, 2006CLIA 05D0881663 · Microscopy
4087 PERALTA BLVD, FREMONT, CA 94536(510) 793-7555(510) 797-5372 Get Directions Write a Review

NPPES record last updated: February 25, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Edmundo Ruiz Davila, M.d.,inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDMUNDO RUIZ DAVILA, M.D.,INC. (NPI 1245281682) is a healthcare organization registered as a family medicine in Fremont, California and active in the NPI registry since May 2006. The organization holds a CLIA Microscopy certificate valid through April 30, 2027 and lists Lucille Joanne Mendoza, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1245281682
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEDMUNDO RUIZ DAVILA, M.D.,INC.
Location Address4087 PERALTA BLVDFremont, CA 94536-4849
Mailing Address4087 Peralta BlvdFremont, CA 94536-4849 · (510) 793-7555 · Fax (510) 797-5372
Phone(510) 793-7555
Fax(510) 797-5372
Organization SubpartNo
Authorized OfficialLucille Joanne MendozaOffice Manager · (510) 793-7555
Enumeration DateMay 12, 2006
Last NPPES UpdateFebruary 25, 2014
✔ NPI 1245281682 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4087 PERALTA BLVD, Fremont, CA 94536
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Other Identifiers 3

Medicare UPIND34069CA
Medicare ID-Type Unspecified00A374100CA · Provider #
Other05D0881663CA · Clia #

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Edmundo Ruiz Davila, M.d.,inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Edmundo Ruiz Davila, M.D.,inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Edmundo Ruiz Davila, M.D.
General Practice
NPI 1699726976
4087 PERALTA BLVD
Fremont, CA 94536
(510) 793-7555
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0881663

Edmundo Ruiz Davila MD Inc · Fremont, CA
Active · expires Apr 30, 2027
CLIA Number05D0881663
Laboratory TypePhysician Office
Certificate Effective DateMay 1, 2025
Certificate Expiration DateApril 30, 2027
Laboratory DirectorEdmundo R. Davilla MD
Laboratory Phone(510) 793-7555
Laboratory LocationEdmundo Ruiz Davila MD Inc4087 Peralta Blvd, Fremont, CA 94538
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edmundo Ruiz Davila, M.D.,inc.'s NPI number?

The NPI number for Edmundo Ruiz Davila, M.D.,inc. is 1245281682. It was assigned to this organization in the NPPES registry on May 12, 2006.

Where is Edmundo Ruiz Davila, M.D.,inc. located?

Edmundo Ruiz Davila, M.D.,inc. is located at 4087 Peralta Blvd, Fremont, CA 94536. The listed phone number is (510) 793-7555.

What is Edmundo Ruiz Davila, M.D.,inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Edmundo Ruiz Davila, M.D.,inc. enrolled in Medicare?

Yes. Edmundo Ruiz Davila, M.D.,inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Edmundo Ruiz Davila, M.D.,inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Edmundo Ruiz Davila, M.D.,inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Edmundo Ruiz Davila, M.D.,inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0881663) is associated with this NPI, valid through April 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edmundo Ruiz Davila, M.D.,inc. was last updated on February 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.