MEDICARE: DR. RICHARD DARRIN BELSKY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	DC22586	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC22586	OTHER	CA	BLUE CROSS
2	DC 22586	OTHER	CA	STATE LICENSE
3	ZZZ05405Z	OTHER	CA	BLUE SHIELD

General Provider Information

NPI Number	:	1518955830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD DARRIN BELSKY D.C.

Provider Business Mailing Address
First Line	:	12264 EL CAMINO REAL
Second Line	:	SUITE 108
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-3058
Country	:	US
Telephone Number	:	858-481-0303
Fax Number	:	858-481-9797

Provider Business Practice Location Address
First Line	:	12264 EL CAMINO REAL
Second Line	:	SUITE 108
City	:	SAN DIEGO
State	:	CA
Zip	:	92130-3058
Country	:	US
Telephone Number	:	858-481-0303
Fax Number	:	858-481-9797

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. RICHARD DARRIN BELSKY D.C.” Practice Location

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