Provider Demographics
NPI:1578897864
Name:KOCHER, RICHARD BARRY JR (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BARRY
Last Name:KOCHER
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7757 MOCKING BIRD DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3330
Mailing Address - Country:US
Mailing Address - Phone:858-229-6963
Mailing Address - Fax:858-278-1123
Practice Address - Street 1:7757 MOCKING BIRD DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-3330
Practice Address - Country:US
Practice Address - Phone:858-229-6963
Practice Address - Fax:858-278-1123
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25048225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist