Provider Demographics
NPI:1780015685
Name:KENDRICK, RICHARD (MD,)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KENDRICK
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1524 MCHENRY AVE
Mailing Address - Street 2:SUITE 235
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4500
Mailing Address - Country:US
Mailing Address - Phone:209-342-5920
Mailing Address - Fax:209-571-6631
Practice Address - Street 1:1524 MCHENRY AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4500
Practice Address - Country:US
Practice Address - Phone:209-342-5920
Practice Address - Fax:209-571-6631
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG339772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology