Provider Demographics
NPI:1366488694
Name:SLATER, RICHARD GIUSEPPI (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:GIUSEPPI
Last Name:SLATER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:GIUSEPPI
Other - Last Name:SLATER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2524 H DELA ROSA SR ST
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-3383
Mailing Address - Country:US
Mailing Address - Phone:831-678-8899
Mailing Address - Fax:831-678-4545
Practice Address - Street 1:2524 H DELA ROSA SR ST
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-3383
Practice Address - Country:US
Practice Address - Phone:831-678-8899
Practice Address - Fax:831-678-4545
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48516207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51087Medicare UPIN
CAAU533ZMedicare PIN
CA00G485161Medicare PIN