Healthcare Provider Details

I. General information

NPI: 1184686313
Provider Name (Legal Business Name): RICHARD PAUL MUSSELMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 HICKORY ST
RED BLUFF CA
96080-2771
US

IV. Provider business mailing address

1335 STANFORD AVE
EMERYVILLE CA
94608-2536
US

V. Phone/Fax

Practice location:
  • Phone: 510-647-5101
  • Fax:
Mailing address:
  • Phone: 510-647-5101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4388
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number020A58040
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: