Individual ProviderMark RichmondEmergency MedicineAllopathic & Osteopathic PhysiciansPractice AddressPueblo At Bath, Santa Barbara, CA 93105(805) 682-7111(800) 358-8179PECOS EnrollmentBased on the most recent information from CMS, provider Mark Richmond is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:36 AM.Profile DetailsProvider ID1336171545Provider TypeIndividualFull NameRichmond, MarkCredentialMDGenderMaleSole ProprietorNoEnumeration Date7/7/2006Last Updated4/30/2010Contact InformationPractice LocationPractice AddressPueblo At Bath, Santa Barbara, CA 93105Phone(805) 682-7111FaxUnlisted FaxMailing LocationMailing AddressPO Box 10040, Westminster, CA 92685-0040Phone(800) 358-8179FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseA54598CaliforniaProvider IdentifiersIDDescriptionIssuerID00A545980DescriptionMedicaidIssuerUnlistedCalifornia