Provider Demographics
NPI:1659441962
Name:CONTRERAS, GERARDO DUENAS (DC)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:DUENAS
Last Name:CONTRERAS
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 1:4826 LANTANA AVE
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-1471
Mailing Address - Country:US
Mailing Address - Phone:925-373-6449
Mailing Address - Fax:
Practice Address - Street 1:4200 EAST AVE
Practice Address - Street 2:STE. B
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4945
Practice Address - Country:US
Practice Address - Phone:925-606-5490
Practice Address - Fax:925-606-6012
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC28469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor