Provider Demographics
NPI:1891854089
Name:OREILLY, RICHARD R (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:OREILLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2510 TWICKENHAM CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-9268
Mailing Address - Country:US
Mailing Address - Phone:661-325-4257
Mailing Address - Fax:661-325-4257
Practice Address - Street 1:2510 TWICKENHAM CT
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-9268
Practice Address - Country:US
Practice Address - Phone:661-325-4257
Practice Address - Fax:661-325-4257
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG10484208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
A37978Medicare UPIN
CA1595717Medicare ID - Type Unspecified