Provider Demographics
NPI:1255837761
Name:DEAN, RILEY ANDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:RILEY
Middle Name:ANDERSON
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6535 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4259
Mailing Address - Country:US
Mailing Address - Phone:225-924-7514
Mailing Address - Fax:225-922-8917
Practice Address - Street 1:200 W. ARBOR DRIVE M/C 8890
Practice Address - Street 2:92013-8890
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92013-8890
Practice Address - Country:US
Practice Address - Phone:619-543-6084
Practice Address - Fax:619-543-3645
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA3378332086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program