Healthcare Provider Details

I. General information

NPI: 1861576852
Provider Name (Legal Business Name): DAVID L. RICHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 ARCH ST
BERKELEY CA
94708-1615
US

IV. Provider business mailing address

1132 ARCH ST
BERKELEY CA
94708-1615
US

V. Phone/Fax

Practice location:
  • Phone: 510-525-1910
  • Fax:
Mailing address:
  • Phone: 510-525-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG21636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: