Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC 18711 | CA |
NPI | 1710159462 |
---|---|
Provider Name | Dr. Richard John Horne |
First Address | Lake Forest, CA 92630-6303 |
Second Address | Lake Forest, CA 92630-6303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2008 |
Last Update Date | 01/04/2008 |