Individual
MR. KEN EH RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5725 RALSTON ST, STE 103, VENTURA, CA 93003-6053
(805) 658-6964
(805) 477-0370
Mailing address
11268 VOLLMER DR, LOMA LINDA, CA 92354-4874
(951) 317-1301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT0188620
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WPT118620A
MEDICARE ID
CA
Enumeration date
06/23/2005
Last updated
12/16/2009
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