Provider Demographics
NPI:1508864448
Name:BARAGER, RICHARD R (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:BARAGER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9610 GRANITE RIDGE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2684
Mailing Address - Country:US
Mailing Address - Phone:858-810-8000
Mailing Address - Fax:858-268-1911
Practice Address - Street 1:3300 VISTA WAY
Practice Address - Street 2:STE B
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-3752
Practice Address - Country:US
Practice Address - Phone:760-967-9900
Practice Address - Fax:760-967-6769
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2015-09-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG52074207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA156007OtherNO. CALIFORNIA PTAN
CAG52074OtherCA LICENSE
CACB226114OtherSO. CALIFORNIA PTAN