Healthcare Provider Details

I. General information

NPI: 1215553003
Provider Name (Legal Business Name): MR. RICHARD VERNON SEARCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 5TH ST
MODESTO CA
95351-3316
US

IV. Provider business mailing address

523 EUCALYPTUS AVE
OAKDALE CA
95361-2509
US

V. Phone/Fax

Practice location:
  • Phone: 360-286-6933
  • Fax:
Mailing address:
  • Phone: 360-286-6933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: