Provider Demographics
NPI:1881865830
Name:RALPH DUMOUCHEL, DC A CHIROPRACTIC CORP
Entity type:Organization
Organization Name:RALPH DUMOUCHEL, DC A CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DUMOUCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:925-798-6300
Mailing Address - Street 1:5167 CLAYTON RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94521
Mailing Address - Country:US
Mailing Address - Phone:925-798-6300
Mailing Address - Fax:925-798-6301
Practice Address - Street 1:5167 CLAYTON RD
Practice Address - Street 2:SUITE C
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94521
Practice Address - Country:US
Practice Address - Phone:925-798-6300
Practice Address - Fax:925-798-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12658111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC12658Medicare UPIN