Provider Demographics
NPI:1659355980
Name:HARPER, RICHART WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:RICHART
Middle Name:WILLIAM
Last Name:HARPER
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 1:451 EAST HEALTH SCIENCES DR
Mailing Address - Street 2:GBSF, SUITE 6510
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616
Mailing Address - Country:US
Mailing Address - Phone:916-734-3564
Mailing Address - Fax:
Practice Address - Street 1:4150 V ST
Practice Address - Street 2:SUITE 3400
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1460
Practice Address - Country:US
Practice Address - Phone:916-734-3564
Practice Address - Fax:916-734-7924
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG079755207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G797550Medicaid
CA00G797550Medicare ID - Type Unspecified
CA00G797550Medicaid