Provider Demographics
NPI:1184837429
Name:RICHMAN, RICHARD LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEE
Last Name:RICHMAN
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 1:4200 PARK BLVD
Mailing Address - Street 2:PMB #131
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-1312
Mailing Address - Country:US
Mailing Address - Phone:510-530-3400
Mailing Address - Fax:510-530-3306
Practice Address - Street 1:1331 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1733
Practice Address - Country:US
Practice Address - Phone:510-530-3400
Practice Address - Fax:510-530-3306
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-0138610111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC-0138610OtherCA CHIROPRACTIC LICENSE #