Provider Demographics
NPI:1952497745
Name:GLASS, RICHARD ALOIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALOIS
Last Name:GLASS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:250 BON AIR RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-1702
Mailing Address - Country:US
Mailing Address - Phone:415-499-6835
Mailing Address - Fax:415-507-4113
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:UNIT B
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-499-6835
Practice Address - Fax:415-507-4113
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2021-12-03
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Provider Licenses
StateLicense IDTaxonomies
CAG805132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry