Picha, Richard Gordon
Picha, Richard Gordon is an sole proprietor health care provider with primary practice located at 1919 University Ave W Ste Tlc, Saint Paul MN 55104-3453. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Picha, Richard Gordon can be contacted via phone (952) 926-6670.Contact Information
Primary practice address
1919 University Ave W Ste Tlc
Saint Paul MN 55104-3453
Phone: (952) 926-6670
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 288 | Minnesota |
Profile Details
NPI number | 1811009970 |
---|---|
LBN Legal business name | Picha, Richard Gordon |
Credentials | Doctor of Podiatric Medicine (DPM) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 31st, 2006 |
Last updated | Feb 12th, 2014 - about 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1811009970 | NPPES |
Other | 2728653 | MEDICA | |
Other | 100466 | MEDICA | |
MEDICAID | 3600355 | MEDICA | |
MEDICAID | 582525300 | MEDICA | |
Other | 480610048 | MEDICA |
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