Provider Demographics
NPI:1871245688
Name:ATANGAN, RICHARD ERIC OFFEMARIA (FNP-BC, NP-C)
Entity Type:Individual
Prefix:
First Name:RICHARD ERIC
Middle Name:OFFEMARIA
Last Name:ATANGAN
Suffix:
Gender:M
Credentials:FNP-BC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 PARK SIERRA DR STE 203
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3071
Mailing Address - Country:US
Mailing Address - Phone:951-687-3400
Mailing Address - Fax:951-687-7630
Practice Address - Street 1:3660 PARK SIERRA DR STE 208
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3071
Practice Address - Country:US
Practice Address - Phone:951-687-2800
Practice Address - Fax:951-687-7290
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-23
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018875363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily