Provider Demographics
NPI:1740069996
Name:RICHARD A BERMUDES, MD PC
Entity type:Organization
Organization Name:RICHARD A BERMUDES, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERMUDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-837-7394
Mailing Address - Street 1:369B 3RD ST # 386
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3581
Mailing Address - Country:US
Mailing Address - Phone:415-906-5337
Mailing Address - Fax:415-406-8371
Practice Address - Street 1:210 ELKS POINT RD STE 103
Practice Address - Street 2:
Practice Address - City:ZEPHYR COVE
Practice Address - State:NV
Practice Address - Zip Code:89448-9801
Practice Address - Country:US
Practice Address - Phone:775-380-8574
Practice Address - Fax:775-298-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty