Healthcare Provider Details

I. General information

NPI: 1558408278
Provider Name (Legal Business Name): RICHARD M APOLLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 CAMINO ALTO SUITE 104
MILL VALLEY CA
94941
US

IV. Provider business mailing address

61 CAMINO ALTO SUITE 104
MILL VALLEY CA
94941
US

V. Phone/Fax

Practice location:
  • Phone: 415-388-5170
  • Fax: 415-388-5115
Mailing address:
  • Phone: 415-388-5170
  • Fax: 415-388-5115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG51648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: