Provider Demographics
NPI:1649287533
Name:QUESADA, RONNIE (DC)
Entity type:Individual
Prefix:DR
First Name:RONNIE
Middle Name:
Last Name:QUESADA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3846 RAILROAD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6528
Mailing Address - Country:US
Mailing Address - Phone:925-439-7323
Mailing Address - Fax:925-439-2829
Practice Address - Street 1:3846 RAILROAD AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6528
Practice Address - Country:US
Practice Address - Phone:925-439-7323
Practice Address - Fax:925-439-2829
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12025111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0120250Medicare UPIN
CADC0120250Medicare ID - Type Unspecified