Healthcare Provider Details

I. General information

NPI: 1659841484
Provider Name (Legal Business Name): AARON RUANO DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 03/23/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27620 LANDAU BLVD STE 3
CATHEDRAL CITY CA
92234-5540
US

IV. Provider business mailing address

1801 ORANGE TREE LN STE 200
REDLANDS CA
92374-4587
US

V. Phone/Fax

Practice location:
  • Phone: 760-322-5090
  • Fax: 760-322-9175
Mailing address:
  • Phone: 909-557-1650
  • Fax: 909-890-0218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT295319
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: