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NPI Code Detail

MEDICARE: DR. FRED III D RICHARDSON MD MSPH

MEDICARE:  DR. FRED III D RICHARDSON  MD MSPH
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
12083P0500XPreventive Medicine/Occupational Environmental Medicine PhysicianC42974CA

General Provider Information

NPI Number : 1760536221
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRED III D RICHARDSON MD MSPH
Provider Business Mailing Address
First Line : 3449 FREEDOM PARK DR
Second Line :
City : N HIGHLANDS
State : CA
Zip : 95660-4607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3449 FREEDOM PARK DR
Second Line :
City : N HIGHLANDS
State : CA
Zip : 95660-4607
Country : US
Telephone Number : 916-708-6709
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2007
Last Update Date : 11/15/2010

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Directions to “ DR. FRED III D RICHARDSON MD MSPH” Practice Location

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