# HENRY A. RICHARDSON, MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447768197
- **Authorized official:** DR. HENRY RICHARDSON MD (OWNER/MD)
- **Authorized official phone:** (909) 709-5646

## Contact information

- **Practice address:** 553 F ST, CHULA VISTA, CA 91910-3515
- **Practice address phone:** (619) 426-8611
- **Mailing address:** 1180 ROSECRANS ST STE 607, SAN DIEGO, CA 92106-2660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/16/2018
- **Last updated:** 06/14/2023