Ellis, Richard Ashley
Ellis, Richard Ashley is an sole proprietor health care provider with primary practice located at 1190 Veterans Blvd Ste C , Redwood City CA 94063-2037. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Ellis, Richard Ashley can be contacted via phone (650) 299-7800.Contact Information
Primary practice address
1190 Veterans Blvd Ste C
Redwood City CA 94063-2037
Phone: (650) 299-7800
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | OS17840 | Florida |
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | 12689 | California |
Profile Details
| NPI number | 1386702140 |
|---|---|
| LBN Legal business name | Ellis, Richard Ashley |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Mar 7th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386702140 | NPPES |
| California | Other | 12689 | CA MEDICAL LICENSE |
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