Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC14573 | CA |
NPI | 1033287222 |
---|---|
Provider Name | Dr. Ruedy Michael Contreras |
First Address | Buena Park, CA 90621 |
Second Address | Brea, CA 92821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 09/07/2007 |