Provider Demographics
NPI:1548323694
Name:RICHARDS, PETER C (MD)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:C
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3838 CALIFORNIA ST
Mailing Address - Street 2:SUITE 612
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-221-0736
Mailing Address - Fax:415-221-3583
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:SUITE 612
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-221-0736
Practice Address - Fax:415-221-3583
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2009-05-22
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Provider Licenses
StateLicense IDTaxonomies
CAG47588208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1366688855OtherTYPE 2 NPI
CA00G475880OtherMEDICARE PROVIDER NUMBER
CABE547ZOtherPTAN
CAA50748Medicare UPIN