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General NPI Number Information
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NPI Number | 1013976745
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Entity Type | Individual
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Provider Name | BRIAN PAUL RICHARDSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 06/11/2020
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Provider Practice Location Address
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Address Line | 1441 FLORIDA AVE
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City | MODESTO
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State | CA
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Zip | 95350-4418
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Country | US
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Telephone | 619-933-4258
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Fax | 858-777-3387
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Provider Business Mailing Address
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Address Line | 2359 LITTLETON CIR
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City | COSTA MESA
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State | CA
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Zip | 92626-6368
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Country | US
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Telephone | 619-933-4258
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Fax | 858-777-3387
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 34538
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A043896
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License Number State | CA
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