Provider Demographics
NPI:1457539371
Name:ALLEGRO, RICHARD CHARLES (DC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHARLES
Last Name:ALLEGRO
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 1:12215 VENTURA BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2533
Mailing Address - Country:US
Mailing Address - Phone:818-505-0816
Mailing Address - Fax:818-505-8623
Practice Address - Street 1:12215 VENTURA BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91604-2533
Practice Address - Country:US
Practice Address - Phone:818-505-0816
Practice Address - Fax:818-505-8623
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17351111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor