Provider Demographics
NPI:1154559433
Name:WRIGHT, RYAN JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 SAN MIGUEL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7818
Mailing Address - Country:US
Mailing Address - Phone:949-226-1715
Mailing Address - Fax:949-861-6428
Practice Address - Street 1:369 SAN MIGUEL DR STE 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7818
Practice Address - Country:US
Practice Address - Phone:949-226-1715
Practice Address - Fax:949-861-6428
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA116607390200000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA116607OtherCALIFORNIA MEDICAL LICENSE