Healthcare Provider Details

I. General information

NPI: 1740598184
Provider Name (Legal Business Name): RICHARD MCCARTHY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2010
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29822 AVENIDA DE LAS BANDERAS SUITE A
RANCHO SANTA MARGARITA CA
92688-2884
US

IV. Provider business mailing address

44 CALLE DE FELICIDAD
RANCHO SANTA MARGARITA CA
92688-2884
US

V. Phone/Fax

Practice location:
  • Phone: 949-292-6137
  • Fax:
Mailing address:
  • Phone: 949-292-6137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberDC26638
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: