Individual
DIXIE D RICHARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11633 SAN VICENTE BLVD, SUITE 310, LOS ANGELES, CA 90049-6514
(310) 326-5949
(310) 326-6239
Mailing address
11633 SAN VICENTE BLVD, SUITE 310, LOS ANGELES, CA 90049-6514
(310) 326-5949
(310) 326-6239
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G57309
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G573090
BLUE SHIELD
CA
01
—
P00062429
RAILROAD MEDICARE
—
Enumeration date
12/01/2006
Last updated
07/08/2007
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