| Doctor Name: | DR. RICHARD KIPP ELLSWORTH |
| NPI Number: | 1093730277 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 20A46140 |
| Business Practice Address: | 460 Greenfield Ave Suite 1 Hanford, CA - 932303500 |
| Business Phone Number: | 5595840141 |
| Business Fax Number: | 5595845711 |
| Mailing Address: | 460 Greenfield Ave, Suite 1 HANFORD |
| State: | CA |
| Postal Code: | 932303500 |
| Phone Number: | 5595840141 |
| Fax Number: | 5595845711 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 08/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 20A46140 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |