Healthcare Provider Details
I. General information
NPI: 1942125182
Provider Name (Legal Business Name): RYLEE LYNN STAHL
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26672 PORTOLA PKWY STE 116
FOOTHILL RANCH CA
92610-1773
US
IV. Provider business mailing address
26672 PORTOLA PKWY STE 116
FOOTHILL RANCH CA
92610-1773
US
V. Phone/Fax
- Phone: 949-518-1220
- Fax:
- Phone: 949-518-1220
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | 310579 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: