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Individual

DR. RICHARD J LONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5201 NORRIS CANYON RD STE 210, SAN RAMON, CA 94583-5405
(925) 933-9868
Mailing address
1450 TREAT BLVD # 300, WALNUT CREEK, CA 94597-2168
(925) 952-2828

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
014674
ME
208800000X
Urology Physician
Primary
G89306
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
331070099
ME
Enumeration date
06/23/2005
Last updated
08/02/2021
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