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General NPI Number Information
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NPI Number | 1568762508
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Entity Type | Organization
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Legal Business Name | DAVID C RYAN, M.D. A MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 10/25/2010
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Provider Practice Location Address
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Address Line | 2931 JARVIS ST
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City | SAN DIEGO
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State | CA
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Zip | 92106-2314
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Country | US
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Telephone | 619-222-2355
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Fax | 619-222-2721
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Provider Business Mailing Address
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Address Line | 2931 JARVIS ST
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City | SAN DIEGO
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State | CA
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Zip | 92106-2314
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Country | US
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Telephone | 619-222-2355
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Fax | 619-222-2721
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAVID CLAUDE RYAN II
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Credential | M.D.
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Telephone | 619-222-2355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G74922
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License Number State | CA
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