Individual
RICHARD R. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 W. 7TH STREET, SAN PEDRO, CA 90732
(310) 514-5250
(310) 514-5445
Mailing address
2374 E PACIFICA PL, RANCHO DOMINGUEZ, CA 90220-6214
(310) 225-3244
(310) 698-7054
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G23337
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G233370
—
CA
Enumeration date
05/17/2006
Last updated
01/27/2016
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