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NPI Code Detail

MEDICARE: RICHARD PRECIADO PA-C

MEDICARE: RICHARD PRECIADO PA-C
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
1363AM0700XMedical Physician AssistantPA16627CA

General Provider Information

NPI Number : 1548263932
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD PRECIADO PA-C
Provider Business Mailing Address
First Line : PO BOX 31309
Second Line :
City : LOS ANGELES
State : CA
Zip : 90031-0309
Country : US
Telephone Number : 323-865-3700
Fax Number :
Provider Business Practice Location Address
First Line : 1516 SAN PABLO ST FL 5
Second Line :
City : LOS ANGELES
State : CA
Zip : 90033-5313
Country : US
Telephone Number : 323-865-3700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 10/27/2023

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Directions to “ RICHARD PRECIADO PA-C” Practice Location

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