Provider Demographics
NPI:1215096151
Name:SKALA, RICHARD KARL (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KARL
Last Name:SKALA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:43575 MISSION BLVD
Mailing Address - Street 2:# 707
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5831
Mailing Address - Country:US
Mailing Address - Phone:510-657-6366
Mailing Address - Fax:510-657-3849
Practice Address - Street 1:43575 MISSION BLVD
Practice Address - Street 2:# 707
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-5831
Practice Address - Country:US
Practice Address - Phone:510-657-6366
Practice Address - Fax:510-657-3849
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 11658111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology