Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | A83636 | CA |
Y | 207RN0300X | Nephrologist | A83636 | CA |
NPI | 1194922625 |
---|---|
Provider Name | Richard Michael Treger |
First Address | Los Angeles, CA 90049-5757 |
Second Address | Sylmar, CA 91342-1437 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 01/11/2021 |