Healthcare Provider Details

I. General information

NPI: 1255823258
Provider Name (Legal Business Name): RYAN M LEY MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 BALZAR CIR
RENO NV
89502-2616
US

IV. Provider business mailing address

PO BOX 8038
RENO NV
89507-8038
US

V. Phone/Fax

Practice location:
  • Phone: 619-268-1274
  • Fax:
Mailing address:
  • Phone: 775-225-3606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN MICHAEL LEY
Title or Position: OWNER
Credential:
Phone: 619-268-1274