Provider Demographics
NPI:1922387158
Name:MYERS, RICHARD (CP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:MYERS
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 GOODYEAR STE 130
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3747
Mailing Address - Country:US
Mailing Address - Phone:949-892-5338
Mailing Address - Fax:
Practice Address - Street 1:1801 PARKCOURT PL.
Practice Address - Street 2:BLDG B
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-5002
Practice Address - Country:US
Practice Address - Phone:949-892-5338
Practice Address - Fax:949-419-6478
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist