Individual
DEAN LOLLER RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3580 CALIFORNIA STREET, SUITE 302, SAN FRANCISCO, CA 94118-1725
(415) 658-7497
(415) 929-1307
Mailing address
PO BOX 320670, SAN FRANCISCO, CA 94132
(415) 658-7497
(415) 929-1307
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G401240
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001800143
BLUE SHIELD HIGHMARK OF P
—
01
—
00G401240
CARE ADVANTAGE
—
01
—
013478
HILL PHYSICIANS MED GRP
—
01
—
5422000G401240
BLUE SHIELD OF CAL
—
01
—
600632
BROWN AND TOLAND MED GRP
—
01
—
942983437
BLUE CROSS PERS CARE
—
01
—
9429834370001
CIGNA HEALTHCARE
—
Enumeration date
09/14/2006
Last updated
06/14/2023
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