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General NPI Number Information
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NPI Number | 1467470450
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Entity Type | Individual
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Provider Name | RICHARD R DALESSANDRO MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 500 CORONA MALL
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-734-6110
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Fax |
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Provider Business Mailing Address
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Address Line | 245 LOGANBERRY ST
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City | ANAHEIM HILLS
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State | CA
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Zip | 92808
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Country | US
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Telephone | 714-282-8488
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10337
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License Number State | CA
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