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General NPI Number Information
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NPI Number | 1073933602
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Entity Type | Organization
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Legal Business Name | TRG BUSINESS CONSULTING DYNAMICS, INC.
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Dates
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Enumeration Date | 04/22/2014
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 7840 MISSION CENTER CT SUITE 102
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City | SAN DIEGO
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State | CA
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Zip | 92108-1319
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Country | US
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Telephone | 619-234-7300
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Fax | 619-234-0500
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Provider Business Mailing Address
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Address Line | 7840 MISSION CENTER CT SUITE 102
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City | SAN DIEGO
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State | CA
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Zip | 92108-1319
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Country | US
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Telephone | 619-234-7300
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Fax | 619-234-0500
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD BARRY DICKER
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Credential | PH.D.
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Telephone | 619-234-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | PSY8772
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License Number State | CA
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