Provider Demographics
NPI:1962409110
Name:PRIER, RICHARD CHARLES (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHARLES
Last Name:PRIER
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:PO BOX 1335
Mailing Address - Street 2:
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-1335
Mailing Address - Country:US
Mailing Address - Phone:805-434-0880
Mailing Address - Fax:805-434-5275
Practice Address - Street 1:292 POSADA LN
Practice Address - Street 2:SUITE D
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4054
Practice Address - Country:US
Practice Address - Phone:805-434-0880
Practice Address - Fax:805-434-5275
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG75247207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
77-0510125OtherTAX ID
77-0510125OtherTAX ID
WG75247PMedicare ID - Type Unspecified