Provider Demographics
NPI:1407032824
Name:KNUDSEN, RICHARD P (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:KNUDSEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 ROWLAND WAY, SUITE 300
Mailing Address - Street 2:PULMONARY AND SLEEP ASSOCIATES OF MARIN
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945
Mailing Address - Country:US
Mailing Address - Phone:415-878-0225
Mailing Address - Fax:415-878-0215
Practice Address - Street 1:100 ROWLAND WAY, SUITE 300
Practice Address - Street 2:PULMONARY AND SLEEP ASSOCIATES OF MARIN
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945
Practice Address - Country:US
Practice Address - Phone:415-878-0225
Practice Address - Fax:415-878-0215
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG43057208000000X, 2080S0012X, 2084N0400X, 2084N0402X, 2084N0600X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11644674248OtherNPI
CA262657160OtherTAX ID
A09138Medicare UPIN