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NPI Code Detail

MEDICARE: JEREMY RICH M.D.

MEDICARE:   JEREMY  RICH  M.D.
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
12084N0400XNeurology PhysicianC151780CA

General Provider Information

NPI Number : 1093885824
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY RICH M.D.
Provider Business Mailing Address
First Line : PO BOX 232410
Second Line :
City : SAN DIEGO
State : CA
Zip : 92193-2410
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3855 HEALTH SCIENCES DR
Second Line :
City : LA JOLLA
State : CA
Zip : 92093-0001
Country : US
Telephone Number : 858-822-6100
Fax Number : 858-657-1274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 10/11/2017

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