Provider Demographics
NPI:1184686313
Name:MUSSELMAN, RICHARD PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PAUL
Last Name:MUSSELMAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1335 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2536
Mailing Address - Country:US
Mailing Address - Phone:510-647-5101
Mailing Address - Fax:
Practice Address - Street 1:345 HICKORY ST
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2771
Practice Address - Country:US
Practice Address - Phone:510-647-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4388207Q00000X
CA020A58040207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM03888FMedicaid
B91184Medicare UPIN