Provider Demographics
NPI:1558437285
Name:PRINTZ, RICHARD H (MD PHD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:PRINTZ
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 SIR FRANCIS DRAKE BLVD
Mailing Address - Street 2:#207
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904
Mailing Address - Country:US
Mailing Address - Phone:415-461-8636
Mailing Address - Fax:415-925-1156
Practice Address - Street 1:599 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:#202
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904
Practice Address - Country:US
Practice Address - Phone:415-461-8636
Practice Address - Fax:415-925-1156
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31741207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G317410Medicaid
00G317410Medicare ID - Type Unspecified
CA00G317410Medicaid