Provider Demographics
NPI:1417133174
Name:CUEVA, LUIS R (DC)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:R
Last Name:CUEVA
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 1:1212 N BROADWAY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-3440
Mailing Address - Country:US
Mailing Address - Phone:714-834-7784
Mailing Address - Fax:714-835-7726
Practice Address - Street 1:1212 N BROADWAY
Practice Address - Street 2:SUITE 120
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-3440
Practice Address - Country:US
Practice Address - Phone:714-834-7784
Practice Address - Fax:714-835-7726
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor