Provider Demographics
NPI:1528400017
Name:RUGGIERO, PEDRO A (DC)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:A
Last Name:RUGGIERO
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 1:1141 N VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1701
Mailing Address - Country:US
Mailing Address - Phone:323-660-9525
Mailing Address - Fax:323-660-2844
Practice Address - Street 1:1141 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1701
Practice Address - Country:US
Practice Address - Phone:323-660-9525
Practice Address - Fax:323-660-2844
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11026111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic