Individual provider Active NPI

Richard A Gottlieb, RN

  • Registered Nurse
  • Burbank, CA
National Provider Identifier
1740874197
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95109444 Issued in CA
Practice address
1050 E Cypress Ave
Burbank, CA 91501-1310
Phone
(310) 975-4802
NPI assigned
Feb 25, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95109444 CA Primary

Addresses

Primary practice location

1050 E Cypress Ave
Burbank, CA 91501-1310

Mailing address

1050 E Cypress Ave
Burbank, CA 91501-1310
Phone (310) 975-4802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
95109444CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
RGX Medical CurrentSince Mar 4, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614211200000",
    "number": "1740874197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E CYPRESS AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915011310",
            "telephone_number": "310-975-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E CYPRESS AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915011310",
            "telephone_number": "310-975-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-25",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95109444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.