Provider Demographics
NPI:1033258389
Name:DEAN, RALPH D (MD)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:D
Last Name:DEAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:91 E GRAND BLVD
Mailing Address - Street 2:SUITE101
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-1340
Mailing Address - Country:US
Mailing Address - Phone:951-735-4569
Mailing Address - Fax:951-735-2442
Practice Address - Street 1:91 E GRAND BLVD
Practice Address - Street 2:SUITE101
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1340
Practice Address - Country:US
Practice Address - Phone:951-735-4569
Practice Address - Fax:951-735-2442
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2016-01-15
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Provider Licenses
StateLicense IDTaxonomies
CAA25818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24586Medicare UPIN