Active NPI
Ruben Hurtado
- Dentist
- Lawndale, CA
National Provider Identifier
1366715062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59291
- Practice address
- 15655 Hawthorne Blvd
Ste. a
Lawndale, CA 90260-2665 - Phone
- (424) 297-0513
- NPI assigned
- Feb 12, 2012
- Last updated
- Feb 2, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 59291 | CA | Primary |
Addresses
Primary practice location
15655 Hawthorne Blvd
Ste. a
Lawndale, CA 90260-2665
Mailing address
15655 Hawthorne Blvd
Ste. a
Lawndale, CA 90260-2665
Phone (424) 297-0513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59291 | CA | MD | Pharmacist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1366715062",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15655 HAWTHORNE BLVD",
"address_2": "STE. A",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902602665",
"telephone_number": "424-297-0513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15655 HAWTHORNE BLVD",
"address_2": "STE. A",
"city": "LAWNDALE",
"state": "CA",
"postal_code": "902602665",
"telephone_number": "424-297-0513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HURTADO",
"first_name": "RUBEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-12",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawndale, CA
- Geoffrey Hsu, O.D.
- Lan Thu Hua
- Nancy-Nghi Le Hua, O.D.
- Timothy J Hunt, M.D.
- La Ronda Hunter, MASTECTOMY FITTER
- Hosea Huynh, OTR/L
- Individual and Family Focus Therapy Inc (Reprocessing Mind And Body Therapy)
- Innley Medical Group Inc.
- Integral Wellness Boutique LLC
- Inter Home Health Care Services, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.