Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | G86627 | CA |
NPI | 1013055011 |
---|---|
Provider Name | Richard J. Knight |
First Address | Oakland, CA 94611-5641 |
Second Address | Oakland, CA 94611-5641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 09/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G866270 | (05) | CA |
C29850 | (02) |