Individual
DR. JEFFREY R RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M D
Contact information
Practice address
4482 MARKET ST, STE 410, VENTURA, CA 93003-7780
(805) 535-4422
(805) 648-4426
Mailing address
4482 MARKET ST, STE 410, VENTURA, CA 93003-7780
(805) 535-4422
(805) 648-4426
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G38557
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G038557
BLUE SHIELD ID#
CA
01
—
G38557
LICENSE #
CA
Enumeration date
08/19/2005
Last updated
11/30/2017
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