Provider Demographics
NPI:1033287222
Name:CONTRERAS, RUEDY MICHAEL
Entity Type:Individual
Prefix:DR
First Name:RUEDY
Middle Name:MICHAEL
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RUEDY
Other - Middle Name:MICHAEL
Other - Last Name:CONTRERAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:5205 SOMERSET ST.
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621
Mailing Address - Country:US
Mailing Address - Phone:714-739-1406
Mailing Address - Fax:
Practice Address - Street 1:710 N. BREA BLVD.
Practice Address - Street 2:SUITE G
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821
Practice Address - Country:US
Practice Address - Phone:714-255-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC14573111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic