Provider Demographics
NPI:1063514446
Name:STRINGHAM, RICHARD V (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:V
Last Name:STRINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18406 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325
Mailing Address - Country:US
Mailing Address - Phone:818-885-5480
Mailing Address - Fax:818-885-5430
Practice Address - Street 1:18406 ROSCOE BLVD
Practice Address - Street 2:NORTHRIDGE FAMILY PRACTICE MEDICAL GROUP INC
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325
Practice Address - Country:US
Practice Address - Phone:818-885-5480
Practice Address - Fax:818-993-1917
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA055824207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A558240Medicaid
WA55824BMedicare ID - Type Unspecified
CA00A558240Medicaid