Provider Demographics
NPI:1992801997
Name:RYAN, DAVID CLAUDE II (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CLAUDE
Last Name:RYAN
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2931 JARVIS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2314
Mailing Address - Country:US
Mailing Address - Phone:619-222-2355
Mailing Address - Fax:619-222-2721
Practice Address - Street 1:2931 JARVIS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92106-2314
Practice Address - Country:US
Practice Address - Phone:619-222-2355
Practice Address - Fax:619-222-2721
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG74922207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330934539OtherTAX ID #
CAG74922Medicare ID - Type Unspecified