Healthcare Provider Details
I. General information
NPI: 1962409110
Provider Name (Legal Business Name): RICHARD CHARLES PRIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/01/2005
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
292 POSADA LN SUITE D
TEMPLETON CA
93465-4054
US
IV. Provider business mailing address
PO BOX 1335
TEMPLETON CA
93465-1335
US
V. Phone/Fax
- Phone: 805-434-0880
- Fax: 805-434-5275
- Phone: 805-434-0880
- Fax: 805-434-5275
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | G75247 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: