Healthcare Provider Details

I. General information

NPI: 1699234559
Provider Name (Legal Business Name): SKALA CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4413 SIERRA DEL SOL
PARADISE CA
95969
US

IV. Provider business mailing address

PO BOX 2379
PARADISE CA
95967-2379
US

V. Phone/Fax

Practice location:
  • Phone: 510-657-6366
  • Fax: 510-657-3849
Mailing address:
  • Phone: 510-657-6366
  • Fax: 510-657-3849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD K SKALA
Title or Position: PRESIDENT
Credential: DC
Phone: 510-657-6366