Provider Demographics
NPI:1790952182
Name:MONOSON, RICHARD IRA (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IRA
Last Name:MONOSON
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 1:15246 LA MAIDA ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1920
Mailing Address - Country:US
Mailing Address - Phone:818-986-2871
Mailing Address - Fax:
Practice Address - Street 1:15246 LA MAIDA ST
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1920
Practice Address - Country:US
Practice Address - Phone:818-986-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17898111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor