Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC26434 | CA |
NPI | 1366514432 |
---|---|
Provider Name | Mr. Richard Arland Loos |
First Address | Del Mar, CA 92014-1828 |
Second Address | Del Mar, CA 92014-3754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 20/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U82721 | (02) | CA |