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General NPI Number Information
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NPI Number | 1710988563
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Entity Type | Individual
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Provider Name | RICHARD KIRK WELSH D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC. 11555 1/2 POTRERO RD.
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City | BANNING
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State | CA
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Zip | 92220
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Country | US
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Telephone | 951-849-4761
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Fax |
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Provider Business Mailing Address
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Address Line | 41133 MARSEILLE CT
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City | MURRIETA
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State | CA
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Zip | 92562-1976
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Country | US
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Telephone | 951-677-8187
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A5620
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License Number State | CA
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