Individual
DR. RICHARD KIPP ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
460 GREENFIELD AVE, SUITE 1, HANFORD, CA 93230-3500
(559) 584-0141
(559) 584-5711
Mailing address
460 GREENFIELD AVE, SUITE 1, HANFORD, CA 93230-3500
(559) 584-0141
(559) 584-5711
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A46140
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020A46140
—
CA
01
—
A46140
STATE LICENSE
CA
Enumeration date
07/12/2006
Last updated
08/15/2008
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