Healthcare Provider Details

I. General information

NPI: 1801931035
Provider Name (Legal Business Name): JAMES M RICHARDS MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8610 S SEPULVEDA BLVD
LOS ANGELES CA
90045-4008
US

IV. Provider business mailing address

8610 S SEPULVEDA BLVD
LOS ANGELES CA
90045-4008
US

V. Phone/Fax

Practice location:
  • Phone: 310-670-1840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG37794
License Number StateCA

VIII. Authorized Official

Name: JAMES RICHARDS
Title or Position: PRESIDENT
Credential:
Phone: 310-670-1840