Healthcare Provider Details
I. General information
NPI: 1447123526
Provider Name (Legal Business Name): RPMD MEDICAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/25/2025
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2845 COCHRAN ST STE B
SIMI VALLEY CA
93065-7905
US
IV. Provider business mailing address
2845 COCHRAN ST STE B
SIMI VALLEY CA
93065-7905
US
V. Phone/Fax
- Phone: 805-504-1904
- Fax:
- Phone: 805-504-1904
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
PARK
Title or Position: OWNER
Credential: MD
Phone: 818-835-7355