Provider Demographics
NPI:1972554806
Name:RICHMAN, MICHAEL FRANK (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FRANK
Last Name:RICHMAN
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 1:1950 SAWTELLE BL
Mailing Address - Street 2:# 145
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025
Mailing Address - Country:US
Mailing Address - Phone:310-481-3939
Mailing Address - Fax:310-481-3949
Practice Address - Street 1:1950 SAWTELLE
Practice Address - Street 2:# 145
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025
Practice Address - Country:US
Practice Address - Phone:310-481-3939
Practice Address - Fax:310-481-3949
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74625207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
H08633Medicare UPIN
CAWG74625BMedicare ID - Type Unspecified