Provider Demographics
NPI:1528130069
Name:RYAN, PATRICK J (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:RYAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14445 OLIVE VIEW DR
Mailing Address - Street 2:6D 129
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342-1437
Mailing Address - Country:US
Mailing Address - Phone:818-364-3393
Mailing Address - Fax:818-364-4593
Practice Address - Street 1:14445 OLIVE VIEW DR
Practice Address - Street 2:6D 111
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342-1495
Practice Address - Country:US
Practice Address - Phone:818-364-3393
Practice Address - Fax:818-364-4593
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC319902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7583Medicare ID - Type Unspecified
E82316Medicare UPIN