Provider Demographics
NPI:1245302264
Name:RIFFEY CHIROPRACTIC INC
Entity type:Organization
Organization Name:RIFFEY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLEO
Authorized Official - Middle Name:SKORDOS
Authorized Official - Last Name:RIFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:916-783-9470
Mailing Address - Street 1:6630 SIERRA COLLEGE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95677-4307
Mailing Address - Country:US
Mailing Address - Phone:916-783-9470
Mailing Address - Fax:916-783-9480
Practice Address - Street 1:6630 SIERRA COLLEGE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95677-4307
Practice Address - Country:US
Practice Address - Phone:916-783-9470
Practice Address - Fax:916-783-9480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ13104-ZOtherBLUE SHIELD GROUP NUMBER
CAT7543TMedicare UPIN
CAZZZ13104-ZOtherBLUE SHIELD GROUP NUMBER
CAZZZ20589ZMedicare ID - Type UnspecifiedMEDICARE ZZ NUMBER