Healthcare Provider Details

I. General information

NPI: 1265896880
Provider Name (Legal Business Name): DAVID RICHARDS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2016
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H200 MERCY CIRCLE
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

PO BOX 55191
CAMP PENDLETON CA
92055-5191
US

V. Phone/Fax

Practice location:
  • Phone: 760-719-4061
  • Fax:
Mailing address:
  • Phone: 760-719-4061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18970
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: