Provider Demographics
NPI:1831277722
Name:FLEMING, RICHARD LEWIS (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LEWIS
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4665 BUSINESS CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-1675
Mailing Address - Country:US
Mailing Address - Phone:707-863-4501
Mailing Address - Fax:
Practice Address - Street 1:4665 BUSINESS CENTER DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-1675
Practice Address - Country:US
Practice Address - Phone:707-863-4501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G346160Medicaid
CA00G346160Medicaid
00G346160Medicare ID - Type Unspecified