Provider Demographics
NPI:1215431937
Name:MAYOCK, PATRICK RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:RYAN
Last Name:MAYOCK
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:RYAN
Other - Middle Name:
Other - Last Name:MAYOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4733 W SUNSET BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6093
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4733 W SUNSET BLVD FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6093
Practice Address - Country:US
Practice Address - Phone:206-462-0659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1636162085P0229X, 2085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology