Healthcare Provider Details

I. General information

NPI: 1164405528
Provider Name (Legal Business Name): DAVID R RIKER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9001
US

IV. Provider business mailing address

200 W ARBOR DR
SAN DIEGO CA
92103-9001
US

V. Phone/Fax

Practice location:
  • Phone: 617-939-6943
  • Fax: 858-822-5338
Mailing address:
  • Phone: 617-939-6943
  • Fax: 858-822-5338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberC53916
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberC53916
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC53916
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: