Provider Demographics
NPI:1952309437
Name:HOLDEN, RICHARD C (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6327 N. FRESNO STREET
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5236
Mailing Address - Country:US
Mailing Address - Phone:559-431-4020
Mailing Address - Fax:559-431-4589
Practice Address - Street 1:6327 N. FRESNO STREET
Practice Address - Street 2:SUITE 104
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5236
Practice Address - Country:US
Practice Address - Phone:559-431-4020
Practice Address - Fax:559-431-4589
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7641207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX76410Medicaid
CAH98861Medicare UPIN
CA020A76411Medicare PIN