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General NPI Number Information
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NPI Number | 1992889299
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Entity Type | Organization
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Legal Business Name | RICHARD M POWELL MD
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5901 W OLYMPIC BLVD STE 504
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City | LOS ANGELES
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State | CA
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Zip | 90036-4633
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Country | US
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Telephone | 323-935-5858
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Fax | 323-935-1212
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Provider Business Mailing Address
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Address Line | 5901 W OLYMPIC BLVD STE 504
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City | LOS ANGELES
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State | CA
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Zip | 90036-4633
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Country | US
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Telephone | 323-935-5858
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Fax | 323-935-1212
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Authorized Official
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Title or Position | OWNER
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Name | RICAHRD M POWELL
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Credential | MD
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Telephone | 323-935-5858
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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 | G27765
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License Number State | CA
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