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:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396824546 | NPPES |
| Virginia | MEDICAID | 005878900 | |
| Virginia | Other | 12085 |
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