MEDICARE: DAVID CHARLES RISH 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
1	207N00000X	Dermatology Physician	G27861	CA
2	207ND0101X	MOHS-Micrographic Surgery Physician	G27861	CA
3	207ND0900X	Dermatopathology Physician	G27861	CA
4	207NI0002X	Clinical & Laboratory Dermatological Immunology Physician	G27861	CA
5	207NS0135X	Procedural Dermatology Physician	G27861	CA

General Provider Information

NPI Number	:	1225045438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID CHARLES RISH M.D.

Provider Business Mailing Address
First Line	:	435 N ROXBURY DR
Second Line	:	SUITE 210
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-5027
Country	:	US
Telephone Number	:	310-625-9330
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 N ROXBURY DR
Second Line	:	SUITE 210
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-5027
Country	:	US
Telephone Number	:	310-625-9330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	02/08/2011

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Directions to “ DAVID CHARLES RISH M.D.” Practice Location

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