Individual
DR. RICHARD MICHAEL DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S ALVARADO ST, STE 407, LOS ANGELES, CA 90057-2353
(213) 483-2470
(213) 483-0476
Mailing address
201 S ALVARADO ST, STE 407, LOS ANGELES, CA 90057-2353
(213) 483-2470
(213) 483-0476
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
C31641
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C316410
—
CA
01
—
31679
MO MEDICAL DOCTOR LICENSE
MO
01
—
C31641
CA MD LICENSE
CA
05
—
GR0009251
—
CA
05
—
GR009250
—
CA
Enumeration date
06/28/2005
Last updated
03/07/2023
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