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General NPI Number Information
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NPI Number | 1639226665
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Entity Type | Organization
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Legal Business Name | ROBERT J RILEY LTD
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 6630 S MCCARRAN BLVD STE A-9
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City | RENO
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State | NV
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Zip | 89509-6135
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Country | US
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Telephone | 775-829-1212
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Fax | 775-829-1179
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Provider Business Mailing Address
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Address Line | 6630 S MCCARRAN BLVD STE A-9
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City | RENO
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State | NV
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Zip | 89509-6135
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Country | US
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Telephone | 775-829-1212
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Fax | 775-829-1179
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT J RILEY
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Credential | MD
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Telephone | 775-829-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 6686
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License Number State | NV
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