Provider Demographics
NPI:1619967353
Name:ZOLLINGER, RICHARD E (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:ZOLLINGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:E
Other - Last Name:ZOLLINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:116 MANOR DR
Mailing Address - Street 2:STE. E
Mailing Address - City:PACIFICA
Mailing Address - State:CA
Mailing Address - Zip Code:94044-1959
Mailing Address - Country:US
Mailing Address - Phone:650-355-8166
Mailing Address - Fax:650-355-8167
Practice Address - Street 1:116 MANOR DR
Practice Address - Street 2:STE. E
Practice Address - City:PACIFICA
Practice Address - State:CA
Practice Address - Zip Code:94044-1959
Practice Address - Country:US
Practice Address - Phone:650-355-8166
Practice Address - Fax:650-355-8167
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC12109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor