Provider Demographics
NPI:1386093359
Name:ARCELAO, RICHARD ANONAS (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ANONAS
Last Name:ARCELAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1855 W REDLANDS BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-3145
Mailing Address - Country:US
Mailing Address - Phone:909-890-0407
Mailing Address - Fax:909-890-0575
Practice Address - Street 1:565 N MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411
Practice Address - Country:US
Practice Address - Phone:909-884-9091
Practice Address - Fax:909-383-7013
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLTRN23660207Q00000X
CAA160057207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine