Provider Demographics
NPI:1932134822
Name:TOMPKINS, RICHARD BRENT (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:BRENT
Last Name:TOMPKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 LOMBARD TRL
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1379
Mailing Address - Country:US
Mailing Address - Phone:530-244-5400
Mailing Address - Fax:530-244-5436
Practice Address - Street 1:1274 LOMBARD TRAIL
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-244-5400
Practice Address - Fax:530-244-5436
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG76216207R00000X, 208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F63858Medicare UPIN