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General NPI Number Information
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NPI Number | 1740069996
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Entity Type | Organization
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Legal Business Name | RICHARD A BERMUDES, MD PC
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 210 ELKS POINT RD STE 103
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City | ZEPHYR COVE
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State | NV
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Zip | 89448-9801
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Country | US
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Telephone | 775-380-8574
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Fax | 775-298-8102
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Provider Business Mailing Address
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Address Line | 369B 3RD ST # 386
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3581
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Country | US
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Telephone | 415-906-5337
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Fax | 415-406-8371
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. RICHARD A BERMUDES
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Credential |
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Telephone | 916-837-7394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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