Healthcare Provider Details

I. General information

NPI: 1518577352
Provider Name (Legal Business Name): MICHAEL RUMINSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 04/11/2024
Certification Date: 04/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CITY PKWY W
ORANGE CA
92868-2941
US

IV. Provider business mailing address

5071 DORADO DR APT 201
HUNTINGTON BEACH CA
92649-5106
US

V. Phone/Fax

Practice location:
  • Phone: 714-834-7788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: