MEDICARE: RICHARD BAILEY DOERING 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	2086S0129X	Vascular Surgery Physician	A28899	CA

General Provider Information

NPI Number	:	1699734897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD BAILEY DOERING M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1218
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92659-0218
Country	:	US
Telephone Number	:	949-631-6002
Fax Number	:	949-631-6982

Provider Business Practice Location Address
First Line	:	351 HOSPITAL RD
Second Line	:	401
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92663-3509
Country	:	US
Telephone Number	:	949-631-6002
Fax Number	:	949-631-6982

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

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	02/23/2015

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