MEDICARE: RICHARD A. BERMUDES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	A85302	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ZZZ05968Z	OTHER	CA	MEDICARE GROUP PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518940774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD A. BERMUDES M.D.

Provider Business Mailing Address
First Line	:	1020 SUNCAST LN STE 108
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9335
Country	:	US
Telephone Number	:	916-932-0380
Fax Number	:	916-932-0381

Provider Business Practice Location Address
First Line	:	1020 SUNCAST LN STE 108
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-9335
Country	:	US
Telephone Number	:	916-932-0380
Fax Number	:	916-932-0381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	04/28/2008

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Directions to “ RICHARD A. BERMUDES M.D.” Practice Location

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