MEDICARE: RICHARD PHAIR MD MEDICAL CORP

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	207L00000X	Anesthesiology Physician	G78581	CA

General Provider Information

NPI Number	:	1134341860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD PHAIR MD MEDICAL CORP

Provider Business Mailing Address
First Line	:	2119 WARFIELD AVE
Second Line	:	B
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-1428
Country	:	US
Telephone Number	:	310-782-5423
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 WARFIELD AVE
Second Line	:	B
City	:	REDONDO BEACH
State	:	CA
Zip	:	90278-1428
Country	:	US
Telephone Number	:	310-782-5423
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD PHAIR
Credential	:	M.D.
Telephone Number	:	310-782-5423

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	08/22/2020

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