Provider Demographics
NPI:1922093483
Name:VIEHE, RICHARD BLAKE (DPM)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BLAKE
Last Name:VIEHE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 AVOCADO AVE
Mailing Address - Street 2:STE 195
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7802
Mailing Address - Country:US
Mailing Address - Phone:714-979-6151
Mailing Address - Fax:714-979-6330
Practice Address - Street 1:1303 AVOCADO AVE
Practice Address - Street 2:STE 195
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7802
Practice Address - Country:US
Practice Address - Phone:714-979-6151
Practice Address - Fax:714-979-6330
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1439213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E14390Medicaid
CAWE1439AMedicare PIN
CAWE1439BMedicare PIN