Individual
RICHARD T BERGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3305 PLACER ST, STE A, REDDING, CA 96001-2364
(530) 243-3687
(530) 243-3383
Mailing address
3305 PLACER ST, STE A, REDDING, CA 96001-2364
(530) 243-3687
(530) 243-3383
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A80467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A804670
—
CA
Enumeration date
12/06/2005
Last updated
09/05/2012
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