Healthcare Provider Details

I. General information

NPI: 1659280212
Provider Name (Legal Business Name): CARLOS PADILLA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

961 MARINA WAY S UNIT H
RICHMOND CA
94804-3762
US

IV. Provider business mailing address

961 MARINA WAY S UNIT H
RICHMOND CA
94804-3762
US

V. Phone/Fax

Practice location:
  • Phone: 510-621-9693
  • Fax:
Mailing address:
  • Phone: 510-621-9693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number37543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: