Provider Demographics
NPI:1043370406
Name:RAYAS, FERNANDO J (DC)
Entity type:Individual
Prefix:DR
First Name:FERNANDO
Middle Name:J
Last Name:RAYAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:FERNANDO
Other - Middle Name:J
Other - Last Name:RAYAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC A
Mailing Address - Street 1:520 WEST 17TH STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706
Mailing Address - Country:US
Mailing Address - Phone:714-973-8911
Mailing Address - Fax:714-973-1023
Practice Address - Street 1:520 WEST 17TH STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706
Practice Address - Country:US
Practice Address - Phone:714-973-8911
Practice Address - Fax:714-973-1023
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor