Organization
RUBEN EZQUERRO DPM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN EZQUERRO DPM (OWNER)
(562) 402-5311
Entity
Organization
Contact information
Practice address
21500 PIONEER BLVD, SUITE 107, HAWAIIAN GARDENS, CA 90716-2600
(562) 402-5311
(562) 402-1407
Mailing address
PO BOX 8877, FOUNTAIN VALLEY, CA 92728-8877
(562) 402-5311
(562) 402-5311
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E40420
—
CA
05
—
000E40421
—
CA
Enumeration date
02/16/2010
Last updated
10/09/2012
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