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General NPI Number Information
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NPI Number | 1972600310
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Entity Type | Individual
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Provider Name | GLENN H. RICHMOND M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 613 21ST ST
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-3318
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Country | US
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Telephone | 714-375-2077
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Fax | 714-375-2082
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Provider Business Mailing Address
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Address Line | 613 21ST ST
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-3318
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Country | US
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Telephone | 714-375-2077
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Fax | 714-375-2082
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A46498
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License Number State | CA
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