Mcclintock, Richard Polson

Mcclintock, Richard Polson is an sole proprietor health care provider with primary practice located at 723 S Dora St , Ukiah CA 95482-5335. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Mcclintock, Richard Polson can be contacted via phone (707) 462-1401.

Contact Information

Primary practice address
723 S Dora St Ukiah CA 95482-5335
Phone: (707) 462-1401
Fax: (707) 462-7415
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G-9547 California
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X G-9547 California

Profile Details

NPI number 1124016712
LBN Legal business name Mcclintock, Richard Polson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 9th, 2005
Last updated Nov 17th, 2008 - about 17 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 1124016712 NPPES
Other 05D061485 CLIA
Other 072727935 CLIA

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