RUBEN A EZQUERRO DPM NPI 1417950304

NPI Information

NPI: 1417950304
Provider Name: RUBEN A EZQUERRO, DPM
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

PECOS Registration: Yes

Address:
21500 PIONEER BLVD
STE 104
HAWAIIAN GARDENS, CA
ZIP 90716
Phone: (562) 402-5311
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Ruben A Ezquerro, DPM is a foot and ankle surgery podiatrist in Hawaiian Gardens, CA with 29 years of experience. Ruben A Ezquerro, DPM NPI is 1417950304. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:1995

The provider's business location address is:

21500 PIONEER BLVD
STE 104
HAWAIIAN GARDENS, CA
ZIP 90716-600
Phone: (562) 402-5311
Fax: (562) 402-1407

The NPI 1417950304 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/24/2005 and was last updated on 11/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	E4042	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000E40421	MEDICAID	CALIFORNIA
2	000E40420	MEDICAID	CALIFORNIA
3	000E40420	OTHER	CALIFORNIA	BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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