Provider Demographics
NPI:1922161298
Name:BELL, RICHARD EDWIN (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:EDWIN
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1860 PENNSYLVANIA AVE STE 145
Mailing Address - Street 2:NORTHBAY NEONATOLOGY & ASSOCIATES INC
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-429-6908
Mailing Address - Fax:707-429-6906
Practice Address - Street 1:300 HOSPITAL DR
Practice Address - Street 2:SUTTER SOLANO MEDICAL CENTER
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589
Practice Address - Country:US
Practice Address - Phone:707-554-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG5727102080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0040030Medicaid
CAGR0040030Medicaid
CA00G572710Medicare ID - Type Unspecified