Provider Demographics
NPI:1629058383
Name:STRICK, RICHARD ALAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALAN
Last Name:STRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 UCLA MEDICAL PLAZA
Mailing Address - Street 2:#660
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-6994
Mailing Address - Country:US
Mailing Address - Phone:310-794-1573
Mailing Address - Fax:310-206-4010
Practice Address - Street 1:100 UCLA MEDICAL PLAZA
Practice Address - Street 2:#660
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-6994
Practice Address - Country:US
Practice Address - Phone:310-794-1573
Practice Address - Fax:310-206-4010
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG27468207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G274681Medicaid
A89451Medicare UPIN
G27468AMedicare ID - Type Unspecified