Provider Demographics
NPI:1023298148
Name:NEIL, RICHARD L (MD, MPH)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:NEIL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 N H ST
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-5039
Mailing Address - Country:US
Mailing Address - Phone:909-381-0803
Mailing Address - Fax:909-381-0823
Practice Address - Street 1:1329 N H ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-5039
Practice Address - Country:US
Practice Address - Phone:909-381-0803
Practice Address - Fax:909-381-0823
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA216172083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine