Provider Demographics
NPI:1932181591
Name:STEIN, RICHARD
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:STEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 REGENTS PARK ROW
Mailing Address - Street 2:SUITE 192
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-9124
Mailing Address - Country:US
Mailing Address - Phone:858-587-7000
Mailing Address - Fax:858-587-8632
Practice Address - Street 1:4150 REGENTS PARK ROW
Practice Address - Street 2:SUITE 192
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-9124
Practice Address - Country:US
Practice Address - Phone:858-587-7000
Practice Address - Fax:858-587-8632
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC20412111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor