Healthcare Provider Details

I. General information

NPI: 1609988864
Provider Name (Legal Business Name): RICHARD L OKEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 REGENT ST SUITE 325
BERKELEY CA
94705-2146
US

IV. Provider business mailing address

2999 REGENT ST SUITE 325
BERKELEY CA
94705-2146
US

V. Phone/Fax

Practice location:
  • Phone: 925-254-9203
  • Fax: 510-841-5650
Mailing address:
  • Phone: 925-254-9203
  • Fax: 510-841-5650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG22744
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: