Picha, Richard Gordon

Picha, Richard Gordon is an sole proprietor health care provider with primary practice located at 1919 University Ave W Ste Tlc, Saint Paul MN 55104-3453. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Picha, Richard Gordon can be contacted via phone (952) 926-6670.

Contact Information

Primary practice address
1919 University Ave W Ste Tlc Saint Paul MN 55104-3453
Phone: (952) 926-6670
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 288 Minnesota

Profile Details

NPI number 1811009970
LBN Legal business name Picha, Richard Gordon
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 31st, 2006
Last updated Feb 12th, 2014 - about 12 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 1811009970 NPPES
Other 2728653 MEDICA
Other 100466 MEDICA
MEDICAID 3600355 MEDICA
MEDICAID 582525300 MEDICA
Other 480610048 MEDICA

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