Provider Demographics
NPI:1801997242
Name:RICHARD B. RIEMER D.O.
Entity type:Organization
Organization Name:RICHARD B. RIEMER D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RONNI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEMER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:916-733-8877
Mailing Address - Street 1:2801 K ST
Mailing Address - Street 2:SUITE 420
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5120
Mailing Address - Country:US
Mailing Address - Phone:916-733-8877
Mailing Address - Fax:916-733-8878
Practice Address - Street 1:2801 K ST
Practice Address - Street 2:SUITE 420
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5120
Practice Address - Country:US
Practice Address - Phone:916-733-8877
Practice Address - Fax:916-733-8878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A50692084N0400X, 2084N0600X, 2084S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Not Answered2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Not Answered2084S0010XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX50690Medicaid
CA020A50691Medicare ID - Type Unspecified
CA00AX50690Medicaid