Provider Demographics
NPI:1184799017
Name:HILLEMAN, RICHARD D (DC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:HILLEMAN
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 1:8237 SIERRA AVE
Mailing Address - Street 2:STE A
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92335-3526
Mailing Address - Country:US
Mailing Address - Phone:909-920-3688
Mailing Address - Fax:909-920-3688
Practice Address - Street 1:8237 SIERRA AVE
Practice Address - Street 2:STE A
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3526
Practice Address - Country:US
Practice Address - Phone:909-428-1818
Practice Address - Fax:909-428-1818
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0174910Medicaid
U47478Medicare UPIN
CADC0174910Medicaid