Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD2018-0785 | NM |
Y | 207PE0004X | Emergency Medical Services | A124072 | CA |
NPI | 1205101227 |
---|---|
Provider Name | Dr. Richard D Tucker |
First Address | San Francisco, CA 94131-2002 |
Second Address | Santa Rosa, CA 95405-4801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2012 |
Last Update Date | 08/01/2021 |