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General NPI Number Information
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NPI Number | 1407052459
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Entity Type | Individual
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Provider Name | HENRY ABLE RICHARDSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 7525 METROPOLITAN DR STE 302
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City | SAN DIEGO
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State | CA
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Zip | 92108-4404
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Country | US
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Telephone | 619-325-1161
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Fax |
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Provider Business Mailing Address
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Address Line | 224 N FAIR OAKS AVE STE 300
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City | PASADENA
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State | CA
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Zip | 91103-3618
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Country | US
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Telephone | 626-696-1400
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | A105294
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License Number State | CA
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