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NPI Code Detail

MEDICARE: DR. RYAN ALEX MCNALLY N.D.

MEDICARE: DR. RYAN ALEX MCNALLY N.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175F00000XNaturopathND711CA
2363A00000XPhysician Assistant52369CA

General Provider Information

NPI Number : 1952550675
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN ALEX MCNALLY N.D.
Provider Business Mailing Address
First Line : 8566 LEPUS RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92126-1609
Country : US
Telephone Number : 774-254-1873
Fax Number :
Provider Business Practice Location Address
First Line : 4110 SORRENTO VALLEY BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1429
Country : US
Telephone Number : 203-576-4108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2008
Last Update Date : 09/01/2016

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