Provider Demographics
NPI:1053526632
Name:NORMAN, RICHARD LESLIE (MD)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LESLIE
Last Name:NORMAN
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:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247
Mailing Address - Country:US
Mailing Address - Phone:559-562-2826
Mailing Address - Fax:559-562-3702
Practice Address - Street 1:21796 ROAD 232
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247
Practice Address - Country:US
Practice Address - Phone:559-562-2826
Practice Address - Fax:559-562-3702
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA-21584207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics