Healthcare Provider Details

I. General information

NPI: 1326539404
Provider Name (Legal Business Name): RIA HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2018
Last Update Date: 12/28/2022
Certification Date: 12/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1390 MARKET ST STE 200
SAN FRANCISCO CA
94102-5404
US

IV. Provider business mailing address

1390 MARKET ST STE 200
SAN FRANCISCO CA
94102-5404
US

V. Phone/Fax

Practice location:
  • Phone: 800-504-5360
  • Fax: 415-558-1764
Mailing address:
  • Phone: 800-504-5360
  • Fax: 415-558-1764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN MENDELSON
Title or Position: PRESIDENT
Credential: MD
Phone: 415-652-1167