Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1245429976 |
---|---|
Provider Name | Mr. Richard Alan Sire |
First Address | Pleasanton, CA 94566-0468 |
Second Address | Pleasanton, CA 94588-8448 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2007 |
Last Update Date | 27/09/2015 |