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General NPI Number Information
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NPI Number | 1205256690
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Entity Type | Organization
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Legal Business Name | RANDI RUELA
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Dates
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Enumeration Date | 04/24/2014
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Last Update Date | 08/10/2021
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Provider Practice Location Address
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Address Line | 710 RIMPAU AVE STE 106
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City | CORONA
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State | CA
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Zip | 92879-5724
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Country | US
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Telephone | 951-428-4135
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Fax | 951-339-3623
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Provider Business Mailing Address
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Address Line | 710 RIMPAU AVE STE 106
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City | CORONA
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State | CA
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Zip | 92879-5724
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Country | US
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Telephone | 951-428-4135
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Fax | 951-339-3623
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Authorized Official
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Title or Position | OWNER, ACUPUNCTURIST, CHIROPRACTOR
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Name | RANDI LYNN RUELA
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Credential | DC, LAC
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Telephone | 951-428-4135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 15916
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License Number State | CA
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