Provider Demographics
NPI:1689637761
Name:CLAVERIA, RICHARD JAMES (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:CLAVERIA
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 1:26921 CROWN VALLEY PKWY
Mailing Address - Street 2:#201
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6501
Mailing Address - Country:US
Mailing Address - Phone:949-348-2250
Mailing Address - Fax:949-348-8904
Practice Address - Street 1:26921 CROWN VALLEY PKWY
Practice Address - Street 2:#201
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6501
Practice Address - Country:US
Practice Address - Phone:949-348-2250
Practice Address - Fax:949-348-8904
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57105207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G571050Medicaid
CA00G571050Medicaid
CAB21887Medicare UPIN