1508836222 NPI number — DR. JAMES MILTON RICHARDS M.D., M.P.H.

Table of content: DR. JAMES MILTON RICHARDS M.D., M.P.H. (NPI 1508836222)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508836222 NPI number — DR. JAMES MILTON RICHARDS M.D., M.P.H.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARDS
Provider First Name:
JAMES
Provider Middle Name:
MILTON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D., M.P.H.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICHARDS
Provider Other First Name:
JAMES
Provider Other Middle Name:
MILTON
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1508836222
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/01/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3790 FLORIDA STREET UNIT C321
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92104
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-420-5948
Provider Business Mailing Address Fax Number:
800-405-2906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7575 METROPOLITAN DRIVE, SUITE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-420-5948
Provider Business Practice Location Address Fax Number:
800-405-2906
Provider Enumeration Date:
01/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083P0901X , with the licence number:  A061341 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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