Individual
RUBEN A EZQUERRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
21500 PIONEER BLVD, STE 104, 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) 402-1407
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4042
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E40420
BLUE SHIELD
CA
05
—
000E40420
—
CA
05
—
000E40421
—
CA
Enumeration date
05/24/2005
Last updated
11/30/2021
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