Provider Demographics
NPI:1366514432
Name:LOOS, RICHARD ARLAND (DC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ARLAND
Last Name:LOOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2528
Mailing Address - Street 2:
Mailing Address - City:DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92014-1828
Mailing Address - Country:US
Mailing Address - Phone:858-755-0889
Mailing Address - Fax:858-755-6618
Practice Address - Street 1:2334 CARMEL VALLEY RD STE B
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-3754
Practice Address - Country:US
Practice Address - Phone:858-755-0889
Practice Address - Fax:858-755-6618
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26434111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26434Medicare ID - Type UnspecifiedMEDICARE #
CAU82721Medicare UPIN