Healthcare Provider Details

I. General information

NPI: 1225599327
Provider Name (Legal Business Name): RYAN N. DUGGAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2019
Last Update Date: 04/22/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4T STREET
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

501 S CHIPETA WAY
SALT LAKE CITY UT
84108-1222
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2566
  • Fax: 415-353-3533
Mailing address:
  • Phone: 801-581-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number13423486-1205
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number13423486-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA202164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: