Provider Demographics
NPI:1467617332
Name:HUNGERFORD, RICHARD D (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:HUNGERFORD
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 1:15550 ROCKFIELD BLVD
Mailing Address - Street 2:B220
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2720
Mailing Address - Country:US
Mailing Address - Phone:949-598-9999
Mailing Address - Fax:949-598-9990
Practice Address - Street 1:76466 MEADOW WAY
Practice Address - Street 2:
Practice Address - City:PORTOLA
Practice Address - State:CA
Practice Address - Zip Code:96122-5100
Practice Address - Country:US
Practice Address - Phone:530-832-9602
Practice Address - Fax:530-832-9602
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18029111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0180290OtherBLUE SHIELD PIN
CADC180294OtherCHIROPRACTIC LICENSE