Provider Demographics
NPI:1578802195
Name:CIPOLONE, RICHARD ALFRED (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALFRED
Last Name:CIPOLONE
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 1:3144 EL CAMINO REAL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2194
Mailing Address - Country:US
Mailing Address - Phone:760-429-9358
Mailing Address - Fax:760-720-2930
Practice Address - Street 1:3144 EL CAMINO REAL
Practice Address - Street 2:SUITE 201
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2194
Practice Address - Country:US
Practice Address - Phone:760-429-9358
Practice Address - Fax:760-720-2930
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC13978111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA111N000000XOtherA.S.H.