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NPI Code Detail

MEDICARE: RYAN OUILLETTE

MEDICARE:   RYAN  OUILLETTE
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
1207X00000XOrthopaedic Surgery Physician7776CA

General Provider Information

NPI Number : 1760016000
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN OUILLETTE
Provider Business Mailing Address
First Line : 100 UCLA MEDICAL PLZ STE 170
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024-7001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 UCLA MEDICAL PLZ STE 170
Second Line :
City : LOS ANGELES
State : CA
Zip : 90024-7001
Country : US
Telephone Number : 858-534-3880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2020
Last Update Date : 04/25/2022

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Directions to “ RYAN OUILLETTE ” Practice Location

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