Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | E1136 | CA |
NPI | 1164401782 |
---|---|
Provider Name | Richard L Bell |
First Address | Long Beach, CA 90804-2169 |
Second Address | Long Beach, CA 90804-2105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 07/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T10788 | (02) | CA |