Provider Demographics
NPI:1700847126
Name:ROTHSCHILD, RICHARD B (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:B
Last Name:ROTHSCHILD
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 1:2241 WANKEL WAY
Mailing Address - Street 2:STE C
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-0190
Mailing Address - Country:US
Mailing Address - Phone:805-983-0922
Mailing Address - Fax:805-983-1997
Practice Address - Street 1:2241 WANKEL WAY
Practice Address - Street 2:STE C
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0190
Practice Address - Country:US
Practice Address - Phone:805-983-0922
Practice Address - Fax:805-983-1997
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49505207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G495050OtherBLUESHIELD
A92909Medicare UPIN
WG49505CMedicare PIN