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General NPI Number Information
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NPI Number | 1003094020
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Entity Type | Organization
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Legal Business Name | RICHARD NIEMEYER, MD, INC.
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Dates
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Enumeration Date | 01/31/2008
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 17709 CHATSWORTH ST
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5604
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Country | US
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Telephone | 818-363-3121
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Fax | 818-366-1728
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Provider Business Mailing Address
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Address Line | 17709 CHATSWORTH ST
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City | GRANADA HILLS
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State | CA
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Zip | 91344-5604
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Country | US
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Telephone | 818-363-3121
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Fax | 818-366-1728
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD SCOTT NIEMEYER
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Credential | M.D.
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Telephone | 818-363-3121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G28871
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License Number State | CA
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