MEDICARE: RICHARD A MAYER MD 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	207RI0200X	Infectious Disease Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	WA79246C	OTHER		PROVIDER TRANSACTION ACCESS NUMBER

General Provider Information

NPI Number	:	1487753448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD A MAYER MD INC

Provider Business Mailing Address
First Line	:	4231 BALBOA AVE STE 218
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5504
Country	:	US
Telephone Number	:	619-462-9010
Fax Number	:	619-287-9058

Provider Business Practice Location Address
First Line	:	4231 BALBOA AVE STE 218
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-5504
Country	:	US
Telephone Number	:	619-754-4955
Fax Number	:	619-287-9058

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD ANDREW MAYER
Credential	:	M.D.
Telephone Number	:	619-462-9010

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	01/17/2019

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