MEDICARE: STARRENDA RICHMAN

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1508408212
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STARRENDA RICHMAN

Provider Business Mailing Address
First Line	:	5731 W SLAUSON AVE STE 210
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6982
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1564 W 36TH PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-4503
Country	:	US
Telephone Number	:	562-986-3253
Fax Number	:

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

Provider Enumeration Date	:	10/14/2019
Last Update Date	:	10/14/2019

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Directions to “ STARRENDA RICHMAN ” Practice Location

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