Ryan, Gordon A

Ryan, Gordon A is an individual health care provider with primary practice located at 1010 Murray Ave , San Luis Obispo CA 93405. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Ryan, Gordon A can be contacted via phone (805) 439-2998.

Contact Information

Primary practice address
1010 Murray Ave San Luis Obispo CA 93405
Phone: (805) 439-2998
Fax: (805) 439-2997
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C145619 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101034688 Virginia
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 0101034688 Virginia
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X C145619 California

Profile Details

NPI number 1396824546
LBN Legal business name Ryan, Gordon A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 6th, 2006
Last updated Jul 19th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396824546 NPPES
Virginia MEDICAID 005878900
Virginia Other 12085

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