Provider Demographics
NPI:1760571954
Name:FOX, RICHARD BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRIAN
Last Name:FOX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 S. SANTA CRUZ AVENUE
Mailing Address - Street 2:STE. 300
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030
Mailing Address - Country:US
Mailing Address - Phone:408-402-2452
Mailing Address - Fax:408-370-0330
Practice Address - Street 1:360 DARDANELLI LANE
Practice Address - Street 2:STE. 2C
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032
Practice Address - Country:US
Practice Address - Phone:408-402-2452
Practice Address - Fax:408-370-0330
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2018-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG67169207RP1001X, 2083P0901X, 2080P0214X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE03104Medicare UPIN
CA00G671690Medicare ID - Type Unspecified