Park, Richard Allen

Park, Richard Allen is an individual health care provider with primary practice located at 2500 Merced Street , San Leandro CA 94577-4201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hospitalist, which is considered as his primary health care specialty. Park, Richard Allen can be contacted via phone (510) 454-1000.

Contact Information

Primary practice address
2500 Merced Street San Leandro CA 94577-4201
Phone: (510) 454-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X A72210 California

Profile Details

NPI number 1295813053
LBN Legal business name Park, Richard Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated May 22nd, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295813053 NPPES
California MEDICAID 00A722100

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