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NPI Code Detail

MEDICARE: ROBERT RAPHAEL HERRICK M.D.

MEDICARE: ROBERT RAPHAEL HERRICK 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
12084N0400XNeurology PhysicianG11329CA

General Provider Information

NPI Number : 1790716306
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT RAPHAEL HERRICK M.D.
Provider Business Mailing Address
First Line : 3220 BLUME DR
Second Line : SUITE 151
City : RICHMOND
State : CA
Zip : 94806-1980
Country : US
Telephone Number : 510-243-2383
Fax Number :
Provider Business Practice Location Address
First Line : 3220 BLUME DR
Second Line : SUITE 151
City : RICHMOND
State : CA
Zip : 94806-1980
Country : US
Telephone Number : 510-243-2383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 07/08/2007

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