Provider Demographics
NPI:1427384882
Name:RICHARDSON, DONALD JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JAMES
Last Name:RICHARDSON
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 1:319 W LAMBERT RD
Mailing Address - Street 2:APT. # 25
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-4058
Mailing Address - Country:US
Mailing Address - Phone:818-681-4196
Mailing Address - Fax:562-902-3398
Practice Address - Street 1:10628 RIVERSIDE DR
Practice Address - Street 2:STE. #5
Practice Address - City:TOLUCA LAKE
Practice Address - State:CA
Practice Address - Zip Code:91602-2358
Practice Address - Country:US
Practice Address - Phone:818-508-6188
Practice Address - Fax:818-508-8405
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31240111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician