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General NPI Number Information
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NPI Number | 1124680624
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Entity Type | Organization
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Legal Business Name | SUSAN M RYAN, DPM
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Dates
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Enumeration Date | 07/03/2019
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Last Update Date | 05/18/2025
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Provider Practice Location Address
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Address Line | 11795 EDUCATION ST STE 230
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City | AUBURN
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State | CA
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Zip | 95602-2469
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Country | US
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Telephone | 530-368-0218
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Fax | 916-435-6372
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Provider Business Mailing Address
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Address Line | 6000 FAIRWAY DR STE 1
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City | ROCKLIN
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State | CA
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Zip | 95677-4245
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Country | US
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Telephone | 303-680-2185
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Fax | 916-435-6372
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN MARGARET RYAN
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Credential | DPM
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Telephone | 303-680-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP1100X
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Taxonomy Name | Podiatric Clinic/Center
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License Number |
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License Number State |
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