Provider Demographics
NPI:1780754911
Name:DINSMORE, RICHARD ALLAN (OMD, LAC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLAN
Last Name:DINSMORE
Suffix:
Gender:M
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1410 ECKMAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-5202
Mailing Address - Country:US
Mailing Address - Phone:619-946-7035
Mailing Address - Fax:619-420-4569
Practice Address - Street 1:272 CHURCH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2718
Practice Address - Country:US
Practice Address - Phone:619-420-7858
Practice Address - Fax:619-420-4569
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2704171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0027040OtherMEDICAL