Provider Demographics
NPI:1245251594
Name:INTERNAL MEDICINE/RICHARD GOBAO, M.D./L.L.C
Entity type:Organization
Organization Name:INTERNAL MEDICINE/RICHARD GOBAO, M.D./L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:GOBAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-279-5372
Mailing Address - Street 1:393 VANADIUM RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1427
Mailing Address - Country:US
Mailing Address - Phone:412-279-5372
Mailing Address - Fax:412-279-5378
Practice Address - Street 1:393 VANADIUM RD
Practice Address - Street 2:SUITE 307
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1427
Practice Address - Country:US
Practice Address - Phone:412-279-5372
Practice Address - Fax:412-279-5378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036621E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty