Healthcare Provider Details

I. General information

NPI: 1568721058
Provider Name (Legal Business Name): RYAN ROGER VICTORIO CHIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2012
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 SOUTH ZEDIKER AVENUE
PARLIER CA
93648-2666
US

IV. Provider business mailing address

212 E 47TH ST APT 28C
NEW YORK NY
10017-2127
US

V. Phone/Fax

Practice location:
  • Phone: 559-646-6618
  • Fax:
Mailing address:
  • Phone: 212-203-7034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA124196
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberA124196
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: