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Individual

MR. JOHN DOUGLAS RICHARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
714 W LODI AVE, LODI, CA 95240-3429
(209) 333-0338
(209) 333-2139
Mailing address
714 W LODI AVE, LODI, CA 95240-3429
(209) 327-8677
(209) 333-2139

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
HA3625
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HA0036250
MEDI-CAL PROVIDER #
CA
Enumeration date
09/26/2006
Last updated
11/05/2013
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