MEDICARE: DR. RICHARD MCCARTHY 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	DC26638	CA

General Provider Information

NPI Number	:	1740598184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD MCCARTHY D.C.

Provider Business Mailing Address
First Line	:	44 CALLE DE FELICIDAD
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-2884
Country	:	US
Telephone Number	:	949-292-6137
Fax Number	:

Provider Business Practice Location Address
First Line	:	29822 AVENIDA DE LAS BANDERAS SUITE A
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-2884
Country	:	US
Telephone Number	:	949-292-6137
Fax Number	:

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

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	01/12/2011

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