Healthcare Provider Details

I. General information

NPI: 1144839580
Provider Name (Legal Business Name): RICHARD A. COMPTON, D.O., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2020
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 FOOTHILL BLVD
LA CANADA CA
91011
US

IV. Provider business mailing address

PO BOX 788
LA CANADA CA
91012-0788
US

V. Phone/Fax

Practice location:
  • Phone: 818-643-7128
  • Fax: 818-514-2383
Mailing address:
  • Phone: 818-643-7128
  • Fax: 818-643-4957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD ALAN COMPTON
Title or Position: PRESIDENT
Credential: DO, MPH
Phone: 818-643-7128