Provider Demographics
NPI:1245446244
Name:RICHARD P. DEFRANCISCI M.D. INC.
Entity type:Organization
Organization Name:RICHARD P. DEFRANCISCI M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEFRANCISCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-279-9204
Mailing Address - Street 1:PO BOX 581
Mailing Address - Street 2:
Mailing Address - City:KELSEYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95451-0581
Mailing Address - Country:US
Mailing Address - Phone:707-279-9204
Mailing Address - Fax:707-279-9204
Practice Address - Street 1:5125 SKYWAY
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-5624
Practice Address - Country:US
Practice Address - Phone:530-876-2520
Practice Address - Fax:530-876-2523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ23094ZMedicare PIN