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Individual
RICHARD GREGORY
Active
Individual
RICHARD GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPSA, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
15519
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15519
PHYSICIAN ASSISTANT
CA
01
—
W17030
GROUP PTAN
CA
Enumeration date
04/18/2007
Last updated
01/16/2020
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