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General NPI Number Information
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NPI Number | 1275543712
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Entity Type | Individual
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Provider Name | CHARLES HERBERT RICHARDS
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Gender | Male
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 04/07/2015
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Provider Practice Location Address
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Address Line | 429 D ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5706
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Country | US
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Telephone | 530-742-1679
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Fax | 530-742-1233
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Provider Business Mailing Address
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Address Line | 429 D ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5706
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Country | US
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Telephone | 530-742-1679
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Fax | 530-742-1233
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7038T
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License Number State | CA
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