Healthcare Provider Details

I. General information

NPI: 1366445298
Provider Name (Legal Business Name): RICHARD D ASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 NORRIS CANYON RD SUITE 230
SAN RAMON CA
94583-5407
US

IV. Provider business mailing address

11875 DUBLIN BLVD SUITE C140
DUBLIN CA
94568-2843
US

V. Phone/Fax

Practice location:
  • Phone: 925-277-7550
  • Fax:
Mailing address:
  • Phone: 925-587-2505
  • Fax: 925-587-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD023533E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG38028
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: