Provider Demographics
NPI:1346725769
Name:MONTANE, RUBEN ALEXANDER (DC)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:ALEXANDER
Last Name:MONTANE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 FLORIDA ST UNIT 7
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2439
Mailing Address - Country:US
Mailing Address - Phone:619-548-2356
Mailing Address - Fax:
Practice Address - Street 1:3069 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-3030
Practice Address - Country:US
Practice Address - Phone:619-300-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor