Provider Demographics
NPI:1619040227
Name:RIORDAN, JOHN W (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:RIORDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:WILLIAM
Other - Last Name:RIORDAN
Other - Suffix:II
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2100 WEBSTER ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2377
Mailing Address - Country:US
Mailing Address - Phone:415-923-3815
Mailing Address - Fax:415-749-5713
Practice Address - Street 1:2100 WEBSTER ST
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2377
Practice Address - Country:US
Practice Address - Phone:415-923-3815
Practice Address - Fax:415-749-5713
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA52155174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A521550Medicaid
CA00A521550Medicaid
CAF78574Medicare UPIN