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Individual
RICHARD BRUCE MEDOFF
Active
Individual
RICHARD BRUCE MEDOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G50802
CA
207R00000X
Internal Medicine Physician
Primary
G50802
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OOG508020
BLUE SHIELD
CA
05
—
OOG508020
—
CA
Enumeration date
11/07/2005
Last updated
12/14/2022
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