Provider Demographics
NPI:1407174246
Name:ZEMLYAK, RUBEN (DC)
Entity Type:Individual
Prefix:DR
First Name:RUBEN
Middle Name:
Last Name:ZEMLYAK
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 1:14623 HAWTHORNE BLVD
Mailing Address - Street 2:103
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-1581
Mailing Address - Country:US
Mailing Address - Phone:310-355-1114
Mailing Address - Fax:310-349-1116
Practice Address - Street 1:14623 HAWTHORNE BLVD
Practice Address - Street 2:103
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-1581
Practice Address - Country:US
Practice Address - Phone:310-355-1114
Practice Address - Fax:310-349-1116
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-25029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor