Individual
RICHARD NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 NEVADA ST, SUSANVILLE, CA 96130-3912
(530) 257-4137
(530) 257-4005
Mailing address
701 NEVADA ST, SUSANVILLE, CA 96130-3912
(530) 257-4137
(530) 257-4005
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2220
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417955113
—
CA
Enumeration date
07/07/2005
Last updated
08/14/2024
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