Provider Demographics
NPI:1962951681
Name:HUME, RICHARD (DC, CCSP, FIAMA)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:HUME
Suffix:
Gender:M
Credentials:DC, CCSP, FIAMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 E STANLEY BLVD
Mailing Address - Street 2:347
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-4008
Mailing Address - Country:US
Mailing Address - Phone:925-200-3755
Mailing Address - Fax:
Practice Address - Street 1:849 E STANLEY BLVD
Practice Address - Street 2:347
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4008
Practice Address - Country:US
Practice Address - Phone:925-200-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20632111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician