Ellis, Richard Ashley

Ellis, Richard Ashley is an sole proprietor health care provider with primary practice located at 1190 Veterans Blvd Ste C , Redwood City CA 94063-2037. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Ellis, Richard Ashley can be contacted via phone (650) 299-7800.

Contact Information

Primary practice address
1190 Veterans Blvd Ste C Redwood City CA 94063-2037
Phone: (650) 299-7800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS17840 Florida
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 12689 California

Profile Details

NPI number 1386702140
LBN Legal business name Ellis, Richard Ashley
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 5th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386702140 NPPES
California Other 12689 CA MEDICAL LICENSE

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