Provider Demographics
NPI:1518993518
Name:RISTAINO, RONALD N (DC)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:N
Last Name:RISTAINO
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 1:35325 DATE PALM DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7014
Mailing Address - Country:US
Mailing Address - Phone:760-321-0647
Mailing Address - Fax:760-321-0657
Practice Address - Street 1:35325 DATE PALM DR
Practice Address - Street 2:SUITE 106
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7014
Practice Address - Country:US
Practice Address - Phone:760-321-0647
Practice Address - Fax:760-321-0657
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25266111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0252660Medicare ID - Type UnspecifiedMEDICARE