Richard L Wacht MD Medical Corp

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A021202 Issued in CA

Legal business name

RICHARD L WACHT MD MEDICAL CORP

Practice address

419 30TH St
Oakland, CA 94609-3303

Phone

(510) 444-4305

Fax

(510) 444-6356

NPI assigned

Aug 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard Lee Wacht, MD

Title

Owner

Phone

(510) 444-4305

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1922010487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 30TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093303",
            "telephone_number": "510-444-4305",
            "fax_number": "510-444-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 30TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093303",
            "telephone_number": "510-444-4305",
            "fax_number": "510-444-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD L WACHT MD MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-13",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "WACHT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-444-4305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A021202",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A021202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID",
            "identifier": "21464656",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "719 4316",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA CORP #",
            "identifier": "0754737",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward J. Rich, MD
• Richard a Kahn MD Inc
• Richard a Nusser MD Inc
• Richard H Lee Jr MD Inc
• Richard H. Mogensen DDS Apc
• Nicole Celeste Richard, SUDRC
• Jacquelyn Richards
• Lawrence Thomas Richards, MD
• Rebecca Richards, M.S.
• Ruth L Richards, M.D.

• Internal Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.