Provider Demographics
NPI:1801218003
Name:RILASCIO
Entity Type:Organization
Organization Name:RILASCIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCHUYLER
Authorized Official - Last Name:DU BOURDIEU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-899-3333
Mailing Address - Street 1:1187 COAST VILLAGE RD
Mailing Address - Street 2:333
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93108-2737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 E COTA ST
Practice Address - Street 2:3
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1683
Practice Address - Country:US
Practice Address - Phone:805-899-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty