Provider Demographics
NPI:1962509067
Name:RIEMER, RICHARD BRIAN (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRIAN
Last Name:RIEMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1805 N CALIFORNIA ST STE 201
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-6032
Mailing Address - Country:US
Mailing Address - Phone:209-645-4005
Mailing Address - Fax:209-645-6344
Practice Address - Street 1:1805 N CALIFORNIA ST STE 201
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6032
Practice Address - Country:US
Practice Address - Phone:209-645-4005
Practice Address - Fax:209-645-6344
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A50692084N0600X, 2084S0010X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX50690Medicaid
CA171236900OtherUS DEPARTMENT OF LABOR
CA171236900OtherUS DEPARTMENT OF LABOR
CAE13990Medicare UPIN