Provider Demographics
NPI:1245429976
Name:SIRE, RICHARD ALAN (CPO)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALAN
Last Name:SIRE
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:PO BOX 5268
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-0468
Mailing Address - Country:US
Mailing Address - Phone:925-484-6400
Mailing Address - Fax:925-484-6497
Practice Address - Street 1:4479 STONERIDGE DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8448
Practice Address - Country:US
Practice Address - Phone:925-484-6400
Practice Address - Fax:925-484-6497
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2015-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5856740004Medicare NSC