Mcclintock, Richard Polson
Mcclintock, Richard Polson is an sole proprietor health care provider with primary practice located at 723 S Dora St , Ukiah CA 95482-5335. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Mcclintock, Richard Polson can be contacted via phone (707) 462-1401.Contact Information
Primary practice address
723 S Dora St
Ukiah CA 95482-5335
Phone: (707) 462-1401
Fax: (707) 462-7415
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | G-9547 | California |
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | G-9547 | California |
Profile Details
| NPI number | 1124016712 |
|---|---|
| LBN Legal business name | Mcclintock, Richard Polson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 9th, 2005 |
| Last updated | Nov 17th, 2008 - about 18 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 | 1124016712 | NPPES |
| Other | 05D061485 | CLIA | |
| Other | 072727935 | CLIA |
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