| Doctor Name: | RUBEN A EZQUERRO |
| NPI Number: | 1417950304 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | E4042 |
| Business Practice Address: | 21500 Pioneer Blvd Ste 104 Hawaiian Gardens, CA - 907162600 |
| Business Phone Number: | 5624025311 |
| Business Fax Number: | 5624021407 |
| Mailing Address: | Po Box 8877, FOUNTAIN VALLEY |
| State: | CA |
| Postal Code: | 927288877 |
| Phone Number: | 5624025311 |
| Fax Number: | 5624021407 |
| NPI Enumeration Date: | 05/24/2005 |
| NPI Last Update Date: | 05/03/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/11/2010 |
| NPI Reactivation Date: | 04/28/2010 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | E4042 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |