Provider Demographics
NPI:1518955830
Name:BELSKY, RICHARD DARRIN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DARRIN
Last Name:BELSKY
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 1:12264 EL CAMINO REAL
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3058
Mailing Address - Country:US
Mailing Address - Phone:858-481-0303
Mailing Address - Fax:858-481-9797
Practice Address - Street 1:12264 EL CAMINO REAL
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3058
Practice Address - Country:US
Practice Address - Phone:858-481-0303
Practice Address - Fax:858-481-9797
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22586111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC22586OtherBLUE CROSS
CADC 22586OtherSTATE LICENSE
CAZZZ05405ZOtherBLUE SHIELD
CAU56289Medicare UPIN
CADC22586OtherBLUE CROSS
CAZZZ05405ZOtherBLUE SHIELD