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General NPI Number Information
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NPI Number | 1396198529
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Entity Type | Individual
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Provider Name | RICHARD MARKUS MD
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Gender | Male
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Dates
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Enumeration Date | 07/23/2016
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Last Update Date | 07/23/2016
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Provider Practice Location Address
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Address Line | 5520 VIA MIRA FLORES
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6883
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Country | US
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Telephone | 805-447-5118
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Fax |
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Provider Business Mailing Address
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Address Line | 5520 VIA MIRA FLORES
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6883
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Country | US
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Telephone | 805-447-5118
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A066768
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License Number State | CA
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