Individual
DANIELLE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
828 5TH ST, IMPERIAL BEACH, CA 91932-2013
(913) 710-2420
Mailing address
828 5TH ST, IMPERIAL BEACH, CA 91932-2013
(913) 710-2420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
127555
CA
Other
Enumeration date
04/01/2012
Last updated
12/08/2022
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