Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E2739 | CA |
Y | 222Z00000X | Podiatrist | E2739 | CA |
NPI | 1013936533 |
---|---|
Provider Name | Dr. Barry A Richmond |
First Address | South Gate, CA 90280-3029 |
Second Address | South Gate, CA 90280-3029 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T11452 | (02) | CA |