Provider Demographics
NPI:1699234559
Name:SKALA CHIROPRACTIC INC
Entity type:Organization
Organization Name:SKALA CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:SKALA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:510-657-6366
Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95967-2379
Mailing Address - Country:US
Mailing Address - Phone:510-657-6366
Mailing Address - Fax:510-657-3849
Practice Address - Street 1:4413 SIERRA DEL SOL
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969
Practice Address - Country:US
Practice Address - Phone:510-657-6366
Practice Address - Fax:510-657-3849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty