MEDICARE: DC-RYAN B SENG PA

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
1	363A00000X	Physician Assistant	PA15984	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74-3050085	OTHER	CA	GROUP TAX ID#
2	PA15984	OTHER	CA	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518159003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DC-RYAN B SENG PA

Provider Business Mailing Address
First Line	:	PO BOX 93723
Second Line	:
City	:	CITY OF INDUSTRY
State	:	CA
Zip	:	91715-3723
Country	:	US
Telephone Number	:	323-277-9010
Fax Number	:

Provider Business Practice Location Address
First Line	:	2643 SANTA ANA ST
Second Line	:
City	:	SOUTH GATE
State	:	CA
Zip	:	90280-2025
Country	:	US
Telephone Number	:	323-277-9010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2007
Last Update Date	:	10/08/2014

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Directions to “ DC-RYAN B SENG PA” Practice Location

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