Provider Demographics
NPI:1164401782
Name:BELL, RICHARD L (DPM)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:BELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1760 TERMINO AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2169
Mailing Address - Country:US
Mailing Address - Phone:562-986-6886
Mailing Address - Fax:562-986-6885
Practice Address - Street 1:1760 TERMINO AVE
Practice Address - Street 2:#309
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2105
Practice Address - Country:US
Practice Address - Phone:562-986-6886
Practice Address - Fax:562-986-6885
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1136213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT10788Medicare UPIN