Provider Demographics
NPI:1710988563
Name:WELSH, RICHARD KIRK (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KIRK
Last Name:WELSH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:41133 MARSEILLE CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-1976
Mailing Address - Country:US
Mailing Address - Phone:951-677-8187
Mailing Address - Fax:
Practice Address - Street 1:RIVERSIDE-SAN BERNARDINO COUNTY INDIAN HEALTH, INC.
Practice Address - Street 2:11555 1/2 POTRERO RD.
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220
Practice Address - Country:US
Practice Address - Phone:951-849-4761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA67780Medicare UPIN