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NPI Code Detail

MEDICARE: RYAN JAY KANEKO MD

MEDICARE:   RYAN JAY KANEKO  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianA82219CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215026869
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN JAY KANEKO MD
Provider Business Mailing Address
First Line : 1600 E HILL ST
Second Line :
City : SIGNAL HILL
State : CA
Zip : 90755-3612
Country : US
Telephone Number : 562-424-6200
Fax Number : 562-427-4634
Provider Business Practice Location Address
First Line : 3200 LONG BEACH BLVD
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-5062
Country : US
Telephone Number : 562-981-6865
Fax Number : 562-595-6471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 12/01/2021

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Directions to “ RYAN JAY KANEKO MD” Practice Location

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