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Individual

DR. RICHARD E FAUSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
39000 BOB HOPE DR, WRIGHT BLDG. SUITE 410, RANCHO MIRAGE, CA 92270-3221
(760) 773-1613
Mailing address
39000 BOB HOPE DR, WRIGHT BLDG. SUITE 410, RANCHO MIRAGE, CA 92270-3221
(760) 773-1613

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
20A 5111
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55062
FDA RADIOLOGY CERT #
CA
Enumeration date
05/09/2006
Last updated
03/18/2016
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