Individual
JEROME RICHARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4405
(209) 578-1211
Mailing address
PO BOX 28128, FRESNO, CA 93729-8128
(559) 436-0871
(559) 436-5221
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G48920
CA
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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