Healthcare Provider Details

I. General information

NPI: 1023071735
Provider Name (Legal Business Name): RICHARD N. FIKE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 09/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4737 EL CAMINO AVE
CARMICHAEL CA
95608-4938
US

IV. Provider business mailing address

4737 EL CAMINO AVE
CARMICHAEL CA
95608-4938
US

V. Phone/Fax

Practice location:
  • Phone: 916-487-3473
  • Fax: 916-487-3483
Mailing address:
  • Phone: 916-487-3473
  • Fax: 916-487-3483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD N. FIKE
Title or Position: OWNER
Credential: PT
Phone: 916-487-3473