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General NPI Number Information
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NPI Number | 1396894911
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Entity Type | Organization
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Legal Business Name | RICHARD CARNOW INC.
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 10/24/2014
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Provider Practice Location Address
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Address Line | 322 N SAN DIMAS AVE
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City | SAN DIMAS
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State | CA
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Zip | 91773-2601
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Country | US
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Telephone | 909-599-0592
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Fax | 909-599-9494
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Provider Business Mailing Address
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Address Line | 322 N SAN DIMAS AVE
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City | SAN DIMAS
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State | CA
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Zip | 91773-2601
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Country | US
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Telephone | 909-599-0592
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Fax | 909-599-9494
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD CARNOW CARNOW
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Credential | DC
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Telephone | 909-599-0592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 16299
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License Number State | CA
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