MEDICARE: TRG BUSINESS CONSULTING DYNAMICS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305S00000X	Point of Service	PSY8772	CA

General Provider Information

NPI Number	:	1073933602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRG BUSINESS CONSULTING DYNAMICS, INC.

Provider Business Mailing Address
First Line	:	7840 MISSION CENTER CT
Second Line	:	SUITE 102
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1319
Country	:	US
Telephone Number	:	619-234-7300
Fax Number	:	619-234-0500

Provider Business Practice Location Address
First Line	:	7840 MISSION CENTER CT
Second Line	:	SUITE 102
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1319
Country	:	US
Telephone Number	:	619-234-7300
Fax Number	:	619-234-0500

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RICHARD BARRY DICKER
Credential	:	PH.D.
Telephone Number	:	619-234-7300

Provider Enumeration Date	:	04/22/2014
Last Update Date	:	06/22/2015

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