Provider Demographics
NPI:1962703595
Name:RICHARDS, WARREN (MD)
Entity type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:RICHARDS
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 1:10110 EMPYREAN WAY
Mailing Address - Street 2:UNIT 103
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90067-3829
Mailing Address - Country:US
Mailing Address - Phone:310-277-4267
Mailing Address - Fax:310-277-4267
Practice Address - Street 1:10110 EMPYREAN WAY
Practice Address - Street 2:UNIT 103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-3829
Practice Address - Country:US
Practice Address - Phone:310-277-4267
Practice Address - Fax:310-277-4267
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE3769207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy