Provider Demographics
NPI:1962482489
Name:DOAN, RICHARD L (MD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:DOAN
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:PO BOX 2287
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93303-2287
Mailing Address - Country:US
Mailing Address - Phone:661-334-1958
Mailing Address - Fax:661-324-4095
Practice Address - Street 1:420 34TH ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2237
Practice Address - Country:US
Practice Address - Phone:661-327-1792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG66469207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG664690Medicaid
CAZZZ21365ZMedicare PIN
CAZZZ21366ZMedicare PIN
CA00G664692Medicare PIN
CAZZZ15998ZMedicare PIN
CAZZZ21367ZMedicare PIN
CA00G664697Medicare PIN
F47025Medicare UPIN
CAOOG664690Medicaid
CAZZZ34009ZMedicare PIN
CA00G664696Medicare PIN
CA00G664693Medicare PIN
CA00G664694Medicare PIN
CAZZZ15999ZMedicare PIN