Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | C33426 | CA |
NPI | 1104981117 |
---|---|
Provider Name | Richard William Fleming |
First Address | Beverly Hills, CA 90210 |
Second Address | Beverly Hills, CA 90210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A87650 | (02) |