Provider Demographics
NPI:1538116207
Name:MEHAFFY, RICK (DC)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:
Last Name:MEHAFFY
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 1:260 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1778
Mailing Address - Country:US
Mailing Address - Phone:650-599-9868
Mailing Address - Fax:650-599-9068
Practice Address - Street 1:260 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1778
Practice Address - Country:US
Practice Address - Phone:650-599-9868
Practice Address - Fax:650-599-9068
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC22082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor