Provider Demographics
NPI:1952369506
Name:SHERWOOD, RICHARD C (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 742186
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-2186
Mailing Address - Country:US
Mailing Address - Phone:650-992-0400
Mailing Address - Fax:650-756-6254
Practice Address - Street 1:1800 SULLIVAN AVE
Practice Address - Street 2:STE 402
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2228
Practice Address - Country:US
Practice Address - Phone:650-992-0400
Practice Address - Fax:650-756-6254
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2013-02-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG35886208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G358860Medicaid
CA00G358860Medicaid