Individual
MARK RICHEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
155 GLASSON WAY, GRASS VALLEY, CA 95945-5723
(530) 274-6107
(530) 274-6059
Mailing address
P.O.1766, INDIANAPOLIS, IN 46206-1766
(530) 241-0473
(530) 241-5377
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G54942
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G549420
—
CA
Enumeration date
07/20/2006
Last updated
01/22/2013
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